兩項新的研究發現, 睡眠呼吸暫停綜合症是一種常見的疾病。它導致打鼾，疲勞和危險的夜間呼吸暫停，有較高的患癌症的風險。大約有2800萬美國人擁有某種形式的睡眠呼吸暫停, 對於睡眠醫生, 這種疾病是最關心的問題。因為睡眠呼吸暫停引起夜間缺氧，這和心血管疾病，肥胖和糖尿病都有關。
在一個新的研究中，研究人員在西班牙的睡眠診所跟踪上千名患者，發現那些具有非常嚴重睡眠呼吸暫停的病人中，有65%以上的風險導致癌症。在第二項研究中，威斯康星州的大約一千五百名政府員工，結果表明，在夜間具有最嚴重呼吸障礙的，死於癌症的機率是沒有呼吸障礙的五倍。兩個研究小組只研究了癌症的診斷和結果，而不是集中在任何特定類型的癌症。
這兩個研究於2012年5月在舊金山美國胸科協會組織的國際會議上發表，研究人員排出了引起癌症的常見危險因素的可能性，如年齡，吸煙，喝酒，體力活動和體重都可能扮演了一個角色。即使調整了這些因素，但是癌症和夜間的呼吸障礙還是保持了關聯。
研究人員想知道是否有類似的關係可能存在於睡眠呼吸暫停的人，睡眠呼吸暫停的人在睡眠中喉部肌肉塌陷，阻斷氣道，引起喘息和打鼾。嚴重的睡眠呼吸暫停每天晚上可產生數百個這樣的事件，因此消耗體內的氧。
研究人員發現，一個人呼吸障礙在晚上越嚴重，死於癌症的可能性就越大。中度呼吸暫停的人被發現死於癌症的機率是沒有呼吸障礙人的兩倍， 而有嚴重呼吸障礙的人死亡的機率是沒有睡眠障礙的4.8倍。
“這是非常驚人的，”F. Javier Nieto 醫生說。他是美國威斯康星大學人口健康科學部門主席和研究人員之一。 “這可能是別的東西，但是這是很難想像的東西，我們沒有控製而導致此。”在第二項研究中，研究人員與西班牙的睡眠網絡採取了稍微不同的方法，沒有研究呼吸暫停患者的癌症死亡率，而是癌症的發病率。他們使用的度量稱為低氧血症指數，指的是多少時間一個人的血液中的氧的水平在夜間下降到低於90％。
約5200人被隨訪七年，在開始這些人沒有癌症。研究人員發現，睡眠過程中，低氧血症，或缺氧越嚴重，一個人越有可能會得癌症。
西班牙的La Fe大學及理工醫院Miguel Angel Martinez-Garcia 醫生是研究項目負責人。他說那些氧含量降至低於90％，並且時長達到12％的睡眠總時間的人， 和氧氣水平在夜間沒有大幅下跌的人相比, 有68％以上患癌症的可能性，睡眠呼吸暫停綜合徵的治療， 如持續氣道正壓通氣，CPAP，保持夜間氣道開放，可能會減少關聯。
癌症協會威斯康星州的研究也沒有特別研究治療呼吸暫停對生存的影響，但是當把接受了CPAP治療的患者從分析中刪除，與癌症的關係變得更強，“這是與低氧血症理論相一致，”Nieto醫生說。
“我會說，這是另外一個例子表明睡眠呼吸暫停對人的健康產生深遠的影響，”他補充說。 “你在睡覺時，沒有了呼吸，是一個嚴重的問題。”
Antonio Q. Chan, MD，FACC, FAHA, RPSGT
美國睡眠醫學，心臟學和內科學
Chanwell診所，心髒病及睡眠障礙診所
1289 S. Park Victoria Drive, Milpitas，CA 95035電話：408586-8866
電子郵件：sleepcardiology@gmail.com
在美國，陳醫生是一個領先的，極少數的聯合委員會認證的心臟和睡眠專家（睡眠心臟科醫生）和被經常邀請的講師。 1993-2012他是美國斯坦福大學醫學院兼職臨床醫學院教授。被評為“最佳睡眠醫生。
My name is James Robert Sanders. I am a 71 year old male, member of the Society of Jesus (The Jesuits). I work at Most Holy Trinity Catholic Church as an assistant to the Pastor.
I came to Doctor Antonio Chan because my previous Cardiologist was going to continue treatment for Congestive Heart Failure in the same manner as he had been for a number of years which was to give me pills and hope for the best. The problem began in 2000 with atrial fibrillation. For which I was medicated. This did not work so after a year of treatments, my doctor suggested an operation called Ablation which worked for about a year. The fibrillation began again and we ablated again. This time they had to implant a pacemaker to keep me alive “because I had cardiac arrest on the table.”
Next I was sent to a have a sleep test and the doctor said that I should try a C-pap machine. I did for about a month and because of the difficulty with getting use to the old machines and the strength of air flow, I discontinued using the machine. An almost fatal mistake, I believe’ the Doctor in this case did not explain the dangers of not using the machine and the importance of its use. His nurses did all or most of the work and I don’t remember sitting down with him for longer than 10 minutes total. Also I was transferred to San Jose in 2002 and soon forgot about the apnea.
Because of the continuation of the problem with atrial fibrillation and worsening heart failure, I started seeing another Cardiologist in San Jose. He never mentioned sleep apnea at any time. We were considering another Ablation. By the time my medical bills were over $300,000. In the mean time I had another hospitalization for Congestive Heart Failure. This time, when released from the hospital and having discovered Dr Antonio Chan through an acquaintance, I made an appointment with him.
I had nothing to lose since I was given 4 months to live by my previous cardiologist.
Dr. Chan is one of the very few board-certified in Cardiology and Sleep Medicine in the U.S. At the time I saw Dr. Chan, he was the only one in California with this very specialized background that I know of.
When I arrived for my first appointment with Dr. Chan, his first question was “do you snore?” “Do you wake up feeling tired?” I told him the story of my heart problems and he began to diagnose the root of the problem. Always carefully explaining to a very concerned patient what we were doing. I have found Dr. Chan to be the most thorough and professional Doctor I have ever had! He takes the time to answer questions and tries to head off any misunderstanding before it happens. His methods insure, I believe, understanding of the problems the patients as to the need for various diagnostic tests and treatments and explains the results exhaustively. After my last hospitalization for CHF, I had an ejection fraction of 26% which I understand is about less than half normal rate of greater than 55% and is consistent with very severe heart failure and if not improved would be fatal.
The results have been spectacular! Within a year my ejection fraction had risen to 36 and within two – it rose to 52% and the last test on this one area was 56%. Overall my heart is near normal in size. The last 3 years my ejection fraction consistently average about 56% and I have lived 5 years longer than I expected.
My heart has been in sinus rhythm for well over two years, so the ICD pacemaker is irrelevant and not needed at this time. My shortness of breath and easy fatigability have disappeared. I went to Catalina Island and hiked without difficulty.
As an example of my recovery and with the approval of both my cardiologist (Dr. Chan} and my Parkinson Doctor I completed a 75 mile walk through Portugal and Spain two months ago. Something I tried to do in 2007 and was unable to complete due to the severe heart failure and atrial fibrillation.
Having carried the heavy BIPAP machine (for sleep apnea) on my back, Dr. Chan was kind enough to provide me a newer, lighter CPAP free of rental charges.
Completing my pilgrimage to Santiago de Campostella (The Way of St. James) has been my life-long dream. I finally had done it!
I attribute these remarkable results to the Care of Dr Antonio Chan.
Brother James Robert Sanders
Most Holy Trinity Church
San Jose, CA