Patients with Kidney Transplants and Sleep Apnea Face Increased Risks According to New Study in the January 2010 Clinical Journal of the American Society of Nephrology
Kidney transplant recipients are already at increased risks for a variety of problems. According to a new Hungarian study patients with sleep apnea face an increased of high blood pressure, heart disease and stroke.

GURNEE, IL, November 22, 2009 /24-7PressRelease/ -- The study included 100 kidney transplant patients and found that 25% had moderate to severe sleep apnea. Similar percentages are found in patients undergoing dialysis leaving both groups at high risk for serious cardiac complications. The study found that Transplant recipients with sleep apnea were more than twice as likely as those without the syndrome to be taking three or more anti-hypertensive drugs. In spite of the drugs these patients still measured higher blood pressure than those without the sleep apnea. Obesity increased a transplant patient's risk of developing sleep apnea similar to non-transplant patients. Previous studies have shown that untreated sleep apnea can also cause obesity.

The study showed that kidney patients who also had sleep apnea had a two-fold risk of heart attacks and strokes. The authors concluded that all kidney transplant patients should be screened for sleep apnea because hypertension associated with sleep apnea is a major risk for cardiac failure. Another study in Nephrol Dial Transplant. 2009 Aug 12. "Prevalence of chronic kidney disease in patients with suspected sleep apnoea," showed reduced Glomerular filtration rates in kidney patients with sleep apnea. And yet another study Nephron Clin Pract. 2009;113(3):c140-7. Epub 2009 Aug 12. "Albuminuria and renal function in obese adults evaluated for obstructive sleep apnea," concluded that "In obese adults, increasing severity of OSA is associated with higher serum creatinine"

The good news is that sleep apnea is easily recognized and treated. CPAP is the gold standard of treatment and is extremely effective. Unfortunately only 23-45% of patients tolerate CPAP and overall patients average only 4-5 hours of use a night. Approximately 25% of patients will love their CPAP machines from the first day and continue with successful use. Patients that do not tolerate CPAP initially rarely become regular users of CPAP. Patients who do not tolerate CPAP can opt for oral appliance therapy that is considered a first line treatment for mild to moderate sleep apnea and an alternative to CPAP for patients with severe apnea who do not tolerate CPAP. The website http://www.ihatecpap.com is an excellent resource to investigate comfortable oral appliances for treating sleep apnea. The site has a find a dentist section but if no local dentist is listed the team will help you find a doctor with expertise in Dental Sleep Medicine in your vicinity. There is an excellent section on the website (http://www.ihatecpap.com/sleep_apnea_dangers.html) discussing other dangers of sleep apnea.

A new website http://www.ihateheadaches.org has recently been created to help chronic headache and migraine patients find answers to difficult headache problems. Headaches and Sleep apnea are closely connected. A report by the NHLBI, National Heart Lung and Blood Institute of the NIH considers sleep apnea to be a Temporomandibular disorder which is a major cause of headaches. The report, "CARDIOVASCULAR AND SLEEP-RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS" can be viewed at: http://www.nhlbi.nih.gov/meetings/workshops/tmj_wksp.pdf

Morning headaches are almost always related to either a TMJ disorder or sleep apnea.

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Ira Shapira
Sleep and Health Journal
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