Research on Sleep disorders and their impacts on health

Abstract

Sleep disorders are known to have impact on health status. One of the most common sleep disorders that have shown to be associated with significant comorbidities are obstructive sleep apnea. There are many studies demonstrating that obstructive sleep apnea increases the risk of many cardiovascularrelated diseases including hypertension, coronary artery disease, stroke, arrhythmia, congestive heart failure, and insulin resistance. Other non‐cardiovascular‐related diseases also have shown clear association with obstructive sleep apnea such as gastro‐esophageal reflux disease, erectile dysfunction, and depression. Vice versa, we have demonstrated that the group with cardiovascular‐related diseases also is known to be associated with more severe obstructive sleep apnea and may deserve obstructive sleep apnea screening 1. We are also currently conducting several research studies on the impact of obstructive sleep apnea on health status including the research on cognition of patients with moderate to severe obstructive sleep apnea and impact of obstructive sleep apnea and its treatment on gestational diabetes mellitus. We observed that interestingly Asians with obstructive sleep apnea have unique clinical characteristics with relatively normal body mass index (BMI) compared to Caucasians 2. Predisposing craniofacial structure is believed to have more impact on obstructive sleep apnea pathogenesis among Asians. Positional sleep apnea, defined by significant reduction of at least 50% in obstructive respiratory events (respiratory disturbance index or RDI) during non‐supine position when comparison was made with supine position is very common among Asians and we reported a prevalence of up to 70% 3. Potential treatment besides continuous positive airway pressure (CPAP) such as the use of positional therapy device or upper airway muscle exercises may be of great benefit among Asians. We conducted a study demonstrated that upper airway muscle exercises for 3 months significantly reduced obstructive events among moderate to severe obstructive sleep apnea patients. We are also currently conducting a research on potential positional therapy device as a novel treatment modality in Thai obstructive sleep apnea patients. However obstructive sleep apnea is not the only sleep disorders effecting health status. Insufficient sleep syndrome and shift work disorder are among the important entities. Both of these entities are shown to be associated with excessive daytime sleepiness which is known to increase risk of motor vehicle collisions and work‐related accident. We are currently conducting a study on uncovering the cause of sleepiness among junior doctors which we hope to identify the prevalence of insufficient sleep syndrome, shift work disorder, and other sleep disorders in this specific group. Despite sleep‐disordered research gaining more interest among the researchers in the past few years, more research is still needed in order to discover its effect on health outcome, improve care for our patients, and for our public safety.