The term evolution can mean a number of things from a theory involving human development to a word that describes how our thinking changes. It is this latter context which brought me to this article.
It has been thought that patients with obstructive sleep apnea (OSA) were at risk for additional problems following a heart attack if the reduction in their nighttime oxygen level was not corrected. Recently, this has been found not to be the case. Contrary to conventional expectations in a study of over 2,800 patients who had an acute coronary event, patients with OSA and moderate to severe nighttime drops in oxygen levels had lower rates of major cardiovascular and cerebrovascular events, lower nonfatal heart attacks and lower mortality rates.
These findings have led to an evolution in our thinking that OSA is not just a sleep disorder but a mixed bag of cardiometabolic issues. There may be things that need to be looked at beyond the usual markers we use in measuring the effects of OSA and reduced oxygen levels in patients with coronary disease.
One thought is that the frequent reductions in oxygen levels in some patients lead to a type of preconditioning. Recurrent episodes of lower oxygen levels lead to adaptive changes in the heart muscle and cause enhanced collateral circulation.
More research and observations are needed in this area, and you should not change your OSA therapy on your own but remember the world does not stand still and evolution continues.
