Cause and Effect 1
Running Head: CAUSE AND EFFECT OF OBESITY AND HYPTERTENSION
Cause and Effect of Obesity and Hypertension on Obstructive Sleep Apnea and its Traditional vs. Non-Traditional Treatment
Mandy Haggard
EastTennesseeStateUniversity
Research in Allied Health 4060
November 4, 2006
Abstract
Cause and Effect of Obesity and Hypertension on Obstructive Sleep Apnea and its
TraditionalVs. Non-Traditional Treatment
By
Mandy Haggard
Many people suffer from various forms of sleep disorders. Perhaps one of the most severe and most common of these is Obstructive Sleep Apnea. The severity associated with this disorder is a loss of oxygen the patient frequently suffers and the combined dangers of a stroke or heart attack. It has long been thought that obesity and hypertension are factors that can directly lead to and even worsen OSA. Due to personal opinion and preference, treatment of these conditions is a debatable topic given that there are several both traditional and non-traditional methods.
Introduction
Over 30 million Americans currently suffer from Obstructive Sleep Apnea. In many cases, this disorder goes unnoticed because few people realize how common it is or how many people really are at risk. A reason for this is that Americans are not adequately educated on the severity of OSA and how harmful it can potentially be. Studies show that if untreated, life-threatening cardiovascular conditions can develop. This shows that its somewhat discreet nature is perhaps one of the most dangerous aspects of the disease. Its commonality in the United States is something that is greatly underestimated. As a matter of fact, adult males alone have a 50/50 chance of acquiring OSA due to several factors that cause them to be predisposed (Dement & Koenigsberg, 2002). Through studying people who are known to have OSA, experts have discovered that many of these patients have other health problems in common that both put them at risk for developing the disease, and worsen dramatically as a result of it. These factors most specifically include moderate to severe hypertension and obesity, and are obviously linked to OSA in some way. In order to treat and prevent all three of these conditions from worsening, treatment must be administered quickly. Aside from the various well-known methods that are used to treat each of these diseases, there are just as many non-traditional natural remedies that for some have proven just as effective.
Problem Statement
Obstructive Sleep Apnea is an extremely common disease that targets a large percentage of the population. It is significantly linked to obesity and hypertension and can lead to even more sever cardiovascular problems in its unsuspecting patients. Treatments for this condition can be approached in several different ways depending on which contributing factor one wants to target. There are many equally effective both traditional and non-traditional treatment available for each condition and it is up to the patient as to which approach they will take: synthetic or natural. The only way a patient can make this decision is to be informed—not only of the risks or OSA but also about the wide range of methods that can serve as treatment.
Significance
The discoveries made in this study could more clearly explain what the true relationship is between three of the most common health conditions affecting Americans today: hypertension, obesity, and Obstructive Sleep Apnea. Also, the information gathered here will hopefully shed light on whether conventional medicine or herbal remedy is a better approach to treating these problems and how an improvement in one can affect the other. It is crucial that those at risk become educated on the many causes, symptoms, treatment options, and potentially dangerous long-term effects of Obstructive Sleep Apnea so that they may better protect their health and improved their quality of life.
Research Questions
These questions represent the framework of the information gathered in this study and show how it can be applied and useful in medical research.
- What is the relationship between hypertension, obesity, and Obstructive Sleep Apnea?
- What are the most common types of drugs that are used to treat disorders related to the cause and effect of Obstructive Sleep Apnea?
- What are some alternative nature-derived remedies that can be used to treat the same related conditions?
- What are some of the main differences between these two therapeutic methods and how can one decide which one is best for them?
Review of Literature
My first focus when reviewing the literature was to look for statistical evidence that Obstructive Sleep Apnea is not only related to obesity and hypertension, but that OSA can actually lead to serious cardiovascular problems. The most conclusive writing that I found on this subject was in an article by Steven Grenard, RRT. He used an excerpt from Chapter 96 of a book called Kryger, Roth, and Dement’s Principles and Practice of Sleep Medicine. S. Javaheri stated in his writing (2005) that
“Cardiovascular disorders are very common, affecting 23% of the population. One of The most significant recent developments in the field has been the recognition that sleepDisorders such as sleep apnea can cause or worsen cardiovascular disease and Conversely, that cardiovascular disorders can cause sleep disorders.”
This information makes it clear that there is a very important cause and effect relationship between two of the most common health disorders in America. This “two way street” between OSA and Cardiovascular diseases can pose a very serious problem for patients because they can suffer from one without any idea that they are at risk for the other, since the symptoms may not have developed yet (Grenard, 2005). One of the best ways for people to protect themselves is to be aware that there is a connection and that early treatment is crucial to avoid complications. “The most dangerous cardiovascular complications that can occur from Obstructive Sleep Apnea include: hypertension, both systemic and pulmonary, heart failure, arrhythmias, transient ischemic attack, stroke, and over the long term, even dementia.” (2005) Obesity is a key factor in this puzzle due to the fact that it is directly related to cardiovascular problems as well as to Obstructive Sleep Apnea. It is a well-known fact that people who are obese have a much greater risk of developing both conditions. This is due to the fact that extra pounds put pressure on the soft palate, causing the muscles that normally hold it up and ensure airway patency, to get tired and weak, thus letting the palate fall back and obstruct the airflow through the larynx. Also, obesity is obviously directly related to cardiovascular problems because of the stress that is put on the heart.
The next thing I focused on when analyzing the literature was to answer the question of which treatments are best applicable for which disorder. OSA itself can be treated either directly or indirectly. The indirect method involves first treating the causes of sleep apnea. The first traditional treatment of hypertension was mentioned in an article for a medication called Coreg, or Carvedilol. This drug “has been shown in a number of studies to help lower blood pressure and has been approved by the FDA.” (“FAQS for Coreg”, 1997-2006). The article highlights some potential side effects that may result from regular use: “shortness of breath, a slow heartbeat, weight gain, fatigue, hypotension, dizziness, or faintness.” Upon taking this approach, the patient must accept these side-effects, but will also see improvements in not only their blood pressure, but in their overall cardiovascular health—which in turn, treats and prevents symptoms of Obstructive Sleep Apnea. On the other hand, there are several strong treatment options available of the non-traditional nature. Most of these remedies involve simple changes in diet. According to an online article from Alternative-Medicine-and-Health.com, eating an increased amount or taking a supplement of vitamin C and garlic can significantly lower a patient’s blood pressure naturally without any side-effects. Garlic has even been known to “reduce systolic blood pressure by 20-30 mmHg and diastolic pressure by 10-20 mmHg.” (“Hypertension”, 2000). Both garlic and Vitamin C can be taken in a safe, all-natural, concentrated form through supplements that are inexpensive and available at any health store.
Obesity can obviously be treated by simply lowering the amount of fat intake included in the patient’s daily diet, or by taking chemically formulated diet pills that speed up the metabolism. But, as with all traditional treatments, diet pills come with a variety of side-effects that almost always include tachycardia—which would not at all be a good choice for an already obese patient that could have existing cardiovascular problems. Therefore, I found while reading the literature that there are also several natural everyday foods that can successfully elicit weight loss as effectively as a traditional diet pill without the harmful side effects. According to a recent study done by the Nutrition and Metabolic Research Center at Scripps Clinic, “researchers have confirmed that the simple act of adding grapefruit and grapefruit juice to one’s diet can result in weight loss.” (Shomon, 2004). Furthermore, I ran across some evidence that adding vinegar to one’s diet can have the same effect on obesity. One article in my literature states that since ancient times, people have been using Apple Cider Vinegar as a folk remedy to help control weight and to speed up the metabolism to help burn fat. According to researchers, this is possible because “it has been discovered that “pectin”, and amazingly high fiber nutrient, is one of the main ingredients in Apple Cider vinegar, and it can actually help you shed pounds by lessening the amount of fats your body absorbs.” (Apple Cider Vinegar, 2002).
The last approach that could be used to treat Obstructive Sleep Apnea is to use the traditional direct treatment of a Continuous Positive Airway Pressure device, or CPAP. These devices are usually used as a last resort, and most patients that use these suffer from the most severe cases of sleep apnea. I chose not to do as much research on this particular method since most patients would prefer to use the indirect methods first. After all, with indirect approaches, the patient is essentially “killing two birds with one stone.”Overall, I was able to find quite a bit of good information on both the relationship between hypertension, obesity, and sleep apnea, and also on many traditional and non-traditional treatments for each. I feel that the literature made it much easier for me to conduct my study.
Methodology
Now that concrete evidence has been found supporting the existence of a relationship between obesity, hypertension, and Obstructive Sleep Apnea, as well as the cause and effect associated with cardiovascular problems, it is time to explore the effectiveness of various traditional and non-traditional treatments associated with these conditions. I decided that the best way to conduct research on this subject was to use a comparative method. In order to best do this, I conducted a study using 3 middle-aged participants, each with 2 or more of the conditions that have been discussed. I decided to compare the outcomes of those who use traditional treatments, with the outcomes experienced by those who use the non-traditional treatments.
My first participant is John, a 34 year old male who suffers from obesity, hypertension, and severe sleep apnea, all of which have been treated using traditional means. To start, I looked into his specific treatment history. His obesity began due to a very poor diet that eventually led to his hypertension. He was put on a strict diet by his doctor to control his weight, but was unable to adhere to the drastic changes. Therefore, his obesity was not ultimately improved. His doctor also prescribed him two hypertension drugs: Lipitor and Coreg. The first, Lipitor, was discontinued because John suffered from several side-effects such as leg pain, sleeplessness, and anxiety. He experienced some of the same side-effects from Coreg, with added fatigue. These drugs did improve his hypertension, but simultaneously seemed to create new problems. Presently, John is still taking Coreg to treat his hypertension, but with less effectiveness than expected. Because of the severity of his sleep apnea, and the presence of his other conditions, John decided to use a direct traditional method to treat his OSA. He underwent a sleep test at a local hospital with the use of a CPAP device. He was very satisfied with the results of using the CPAP and stated that “he hadn’t sleep that well in years.” The hospital gave him his own and he returned home to use it himself on a nightly basis. Since being given his CPAP, John has experienced marked improvements in his sleep, and hopefully with continued use, his hypertension will improve as well. (Personal communication, November 4, 2006).
My second participant, Jimmy, suffers from hypertension and Obstructive Sleep Apnea and uses non-traditional, indirect methods of treatment. In inquiring about the history of his conditions, I found that variations in his diet have proven to be the most effective treatments for him. He told me that he used to suffer from very severe sleep apnea and hypertension, but was also overweight. His first reaction was to see his doctor to help control his weight and blood pressure, while unaware that these conditions were directly related to his sleep apnea. Like my first participant, he was prescribed Coreg. He too, experienced a list of side-effects including sleeplessness, leg pain, and in his case, even stomach cramps. In time, Jimmy became unwilling to deal with these added symptoms and terminated his use of Coreg as a treatment for his hypertension. After the failure of the prescription drug, he decided to take a more natural approach. First, he did some of his own research on natural treatments for hypertension and obesity. He immediately modified his diet to include little fats, salt, and fried foods. He also added a daily mixture of grapefruit juice and vinegar to his diet. After one year, he had shed 45 pounds and his diastolic blood pressure had dropped by approximately 20mmHg. I noted that this improvement took substantially longer to achieve than it would have if Jimmy had stayed on Coreg, but also that he was able to accomplish this without any negative side effects by using the non-traditional approach. Furthermore, Jimmy said that after losing the weight, his sleep apnea seemed to disappear, which seems to be a direct result of overall health. He feels that his hypertension and sleep apnea would have definitely worsened had he not taken drastic measures to improve his diet and lose weight. This study seems to further solidify the idea that there is a clear relationship between all of these conditions and that by treating one, the others can be treated as well. (Personal communication, November 8, 2006).
Discussion
Both the research I conducted, and the literature that I reviewed supported my original theory that obesity, hypertension, and Obstructive Sleep Apnea are interrelated. There were even specific quotes included in the literature that highlighted the direct relationship of cardiovascular disease with these conditions. Also, it was very clearly shown through my participants that in treating one of these disorders, many other facets of overall health can be improved as well, while also preventing serious complications from developing in the future. This proves to be a very good indication to promote this knowledge so that those effects by these conditions are aware of the risks involved.
The traditional treatment methods indicated for these conditions proved to have both positive and negative effects on the patient. Both of my participants experienced moderately severe side-effects while taking a prescribed medication for hypertension, although they did show fair improvement in their blood pressure. The non-traditional treatments used by my second participant seemed to be more effective while posing no notable side-effects whatsoever.
Conclusion
In review of all research gathered on this topic, I have found significant answers to each one of my original research questions. According to my sources, there is significant evidence that both obesity and hypertension not only cause and worsen Obstructive Sleep Apnea, but that they can become an effect of Obstructive Sleep Apnea. Furthermore, it was discovered and documented in my literature that cardiovascular diseases play an important role in patients with OSA, and can result over time if the condition is not treated. Both traditional and non-traditional treatments are available to treat each one of these conditions. It was found that in severe cases of sleep apnea, it is better to directly treat it with the use of a CPAP. However, with moderate cases, indirect methods can be used which include treating the related conditions first. According to my participants, traditional treatments offer more side-effects than they do effectiveness, but they seem to generate at least minimal results relatively quickly, while non-traditional treatments carry no side-effects and optimal effectiveness, but take longer to generate results.