SUNDAY, May 20 (HealthDay News) — Sleep apnea has already been linked to a host of adverse health problems, such as high blood pressure and heart disease. Now, new research suggests that in people who already have cancer, the sleep disorder may raise their risk of dying from cancer.
People with the most severe sleep apnea — those who have 30 or more episodes of low or no oxygen in an hour of sleep — had almost five times the risk of cancer death compared to someone without sleep apnea.
“Sleep apnea is the periodic pausing of breathing during sleep that results in drops in oxygen levels in your blood. It causes snoring and sleepiness during the day,” explained study author Dr. Javier Nieto, chair of the department of population health sciences at the University of Wisconsin School of Medicine and Public Health, in Madison.
“Aside from being an annoyance to your spouse, family members and maybe even your neighbors depending on how loud your snoring is, sleep apnea is a severe problem. Drowsiness and sleepiness during the day increase the risk of accidents, and sleep apnea is associated with cardiovascular disease, heart disease, strokes, hypertension and cardiovascular mortality. Now, we see this new angle: an increase in cancer mortality,” said Nieto.
Nieto is scheduled to present the study Sunday at the American Thoracic Society International Conference, in San Francisco.
Nieto said the new study was suggested by researchers from the University of Barcelona in Spain who found that when mice were deprived of oxygen periodically, skin cancer tumors grew faster in the mice. And, cancer cells in the lab that are deprived of oxygen produce molecules that stimulate the growth of blood vessels in an attempt to get more oxygen, he said.
Nieto and the Spanish researchers wondered if this effect was the same in humans. To test that theory, they reviewed data from more than 1,500 people included in the Wisconsin Sleep Cohort. This study included 22 years of mortality data, as well as information from sleep studies.
The researchers adjusted the data to account for age, sex, body mass, smoking and other factors that might affect the risk of cancer death, and they found that sleep apnea increased the risk of cancer death. They also found that the more severe the sleep apnea, the more likely someone was to die from cancer.
People with mild sleep apnea — five to 14.9 episodes of low or no oxygen in an hour — had a 10 percent increased risk of cancer death, while those with moderate sleep apnea — 15 to 29.9 episodes of low or no oxygen in an hour — had double the risk of cancer death. Those with severe sleep apnea — more than 30 episodes of low or no oxygen in an hour — had a 4.8 times higher risk of cancer death.
Nieto said the study didn’t prove a cause-and-effect relationship, but the association was quite strong. And, he noted that the findings were consistent in humans, animals and in cells.
He added that there is also a plausible mechanism for this association. When you have cancer and you repeatedly have episodes of low or no oxygen, the cancer cells “try to compensate for the lack of oxygen by growing additional blood vessels to get more oxygen. It’s a defense mechanism,” Nieto said. And, as those blood vessels keep growing, it helps the tumor to spread, he explained.
Dr. Steven Park, a sleep medicine specialist and otorhinolaryngologist at Montefiore Medical Center in New York City, said he wasn’t surprised by the findings.
“This goes along with the link between sleep apnea and pretty much every chronic medical condition out there,” Park said. But, he added that this study’s findings need to be confirmed in other studies, and ideally be published in a peer-reviewed journal. Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed medical journal.
“Anyone with snoring, severe daytime fatigue, lack of memory or focus, high blood pressure, diabetes, and even someone who has to get up to go to the bathroom at night should be screened for sleep apnea,” Park said. He added that it’s possible to have sleep apnea without snoring, especially for women. So, if you’re getting enough sleep at night, yet still feel tired during the day, it’s important to bring this up to your doctor.
Park said there are home-monitoring devices that can be used to screen people at home initially.
Nieto said that treating sleep apnea will improve your quality of life, as well as reduce your risk of high blood pressure and cardiovascular disease. And, if you have cancer, he said, treating sleep apnea may help increase your odds of surviving cancer
Sleep apnea and other disorders may be helped by foods rich in Tryptophan (5-HTP to up serotonin levels in the brain)
5-hydroxytryptophan (5-HTP) is a chemical that the body makes from tryptophan (an essential amino acid, which you get from food). After tryptophan is converted into 5-HTP, the chemical is then changed into another chemical called serotonin (a neurotransmitter, which relays signals between brain cells). 5-HTP dietary supplements help raise serotonin levels in the brain. Since serotonin helps regulate mood and behavior, 5-HTP may have a positive effect on sleep, mood, anxiety, appetite, and pain sensation.
5-HTP is not found in the foods we eat, although tryptophan is. Eating foods with tryptophan does not increase 5-HTP levels very much, however. As a supplement, 5-HTP is made from the seeds of an African plant called Griffonia simplicifolia.
In 1989, the presence of a contaminant called Peak X was found in tryptophan supplements. Researchers believed that an outbreak of eosinophilic myalgia syndrome (EMS, a potentially fatal disorder that affects the skin, blood, muscles, and organs) could be traced to the contaminated tryptophan, and the U.S. Food and Drug Administration pulled all tryptophan supplements off the market. Since then, Peak X was also found in some 5-HTP supplements, and there have been a few reports of EMS associated with taking 5-HTP. However, the level of Peak X in 5-HTP was not high enough to cause any symptoms, unless very high doses of 5-HTP were taken. Because of this concern, however, you should talk to your health care provider before taking 5-HTP, and make sure you get the supplement from a reliable manufacturer. (See “Precautions” section.)
5-HTP may help treat a wide variety of conditions related to low serotonin levels, including the following, but there is not much evidence for any of these uses:
Some small studies indicate that 5-HTP may work as well as certain antidepressant drugs to treat people with mild-to-moderate depression. Like the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs), which includes fluoxetine (Prozac) and sertraline (Zoloft), 5-HTP increases the levels of serotonin in the brain. One study compared the effects of 5-HTP to fluvoxamine (Luvox) in 63 people and found that those who were given 5-HTP did just as well as those who received Luvox. They also had fewer side effects than the Luvox group. However, these studies were too small to say for sure if 5-HTP works. More and larger studies are needed.
Three studies have suggested that 5-HTP can improve symptoms of fibromyalgia, including pain, anxiety, morning stiffness, and fatigue. Many people with fibromyalgia have low levels of serotonin, and doctors often prescribe antidepressants. Since 5-HTP, like antidepressants, raises levels of serotonin in the brain, it may work too. However, it does not work for all people with fibromyalgia, and more studies are needed to understand its effect.
In one study, people who took 5-HTP went to sleep quicker and slept more deeply than those who took placebo. These researchers recommend 200 – 400 mg at night to stimulate serotonin, but it may take 6 – 12 weeks to be fully effective.
Migraines and Headaches
Antidepressants are sometimes prescribed for migraine headaches. Some studies suggest that high doses of 5-HTP may help people with various types of headaches, including migraines. However, the evidence is mixed, with other studies showing no effect.
A few small studies have looked at whether 5-HTP can help people lose weight. In one study, those who took 5-HTP ate fewer calories, although they were not trying to diet, compared to those who took placebo. Researchers believe 5-HTP led people to feel more full (satiety) after eating, so they ate less.
A follow-up study, which compared 5-HTP to placebo during a diet and non-diet period, found that those who took 5-HTP lost about 2% of body weight during the non-diet period and another 3% when they dieted. Those taking placebo did not lose any weight. However, doses used in these studies were high, and many people had nausea as a side effect. If you are seriously overweight, see your health care provider before taking any weight-loss aid. Remember that you will need to change your eating and exercise habits to lose more than a few pounds.
You can’ t get 5-HTP from food. The amino acid tryptophan, which the body uses to make 5-HTP, can be found in turkey, chicken, milk, potatoes, pumpkin, sunflower seeds, turnip and collard greens, and seaweed.
5-HTP is made from tryptophan in the body, or can be taken as a supplement. Supplements are made from extracts of the seeds of the African tree Griffonia simplicifolia. 5-HTP can also be found in many multivitamin and herbal preparations.
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