New research is suggesting that cholesterol may play an important role in the risks related to sleep apnea. Sleep apnea risks seemed to be higher for people with high cholesterol levels, and there was some evidence that statin use could reduce these risks. However, it’s important to remember that this connection hasn’t been proven, and, even if it were, statin risks may make them a less desirable treatment than either CPAP or oral appliances.
A Deadly Mystery
One of the questions that researchers set out to answer seems like a simple one: why is sleep apnea so deadly? On the one hand, it’s easy to see how sleep interruptions and oxygen deprivation could cause such serious dangers like heart attack, stroke, and dementia. But on the other hand, the dangerous effects of sleep apnea are more serious than related conditions which cause higher levels of oxygen deprivation, and researchers didn’t really know why.
The key, new research suggests, may be cholesterol and the protein CD59, which helps protect cells from injury to their cell membrane. Researchers showed that, in a low-oxygen environment, cells have difficulty dealing with high cholesterol levels inside their membrane, and that they pull CD59 from the membrane to help deal with the problem. This creates a CD59 deficiency on the cell membranes.
With CD59, the cells are protected, but without CD59, they experience inflammation and progressively weaken and eventually die. This, researchers say, is what makes sleep apnea deadly. CD59 deficiency causes the breakdown of red blood cells, which has been shown to contribute to clogged arteries and stroke. It’s also been linked to nerve damage associated with Alzheimer’s disease, which is another serious danger of sleep apnea.
Could Statins Help?
But not all patients seemed to experience this CD59 shortage. The patients that didn’t were on statins, a drug commonly-prescribed to help control cholesterol levels. Researchers speculate that statins could help counteract the effects of sleep apnea by mediating the effects of cholesterol.
This remains speculative, and it will be a long time before we can say that statins will actually provide benefit for people with sleep apnea. And currently the only suggestion is that they could help with cardiovascular problems, and not metabolic problems or mental problems related to waking and sleep loss. And they probably will never help with the snoring component.
But prescribing statins for sleep apnea has its own problems. First, statins are one of the most overprescribed drugs in the US. Under current guidelines, for some indications perhaps only one in 140 patients will actually benefit from statins. However, about one in 10 will experience serious, even disabling muscle pain. And about one in 50 will develop type 2 diabetes because of the drug. When we consider that the risk of type 2 diabetes is already elevated among people with sleep apnea, it starts to look like treating sleep apnea with statins is a singularly bad idea.
With these serious concerns about the safety and effectiveness of statins, we will need to make absolute sure that there is a proven benefit of statins before we recommend using them for sleep apnea.
But what we do recommend is considering all treatment options that have been proven effective for sleep apnea. Your doctor may have prescribed you CPAP for sleep apnea, but that’s not the only treatment, and it might not be the best sleep apnea treatment for you. If you want to learn more about other options for treating sleep apnea in Detroit, please call (248) 825-8277 for an appointment with a sleep dentist at the Michigan Center for TMJ & Sleep Wellness in Troy.