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There isn't really a blood test for sleep apnea. But a very simple lab test can give you and your doctor a good idea of whether your snoring that keeps your spouse, your kids, your pets, or maybe even your neighbors awake is causing heart damage.

Lots of people snore. Some people snort and stop breathing over and over again throughout the night. When whatever is going on with airways causes a repeated cessation of breathing, sometimes up to 40 times an hour, the likely diagnosis is obstructive sleep apnea. This condition is more than an annoyance. It's a potentially deadly disease.

About two percent of women and about four percent of men have sleep apnea [1]. Interruption of breathing causes oxygen levels in the bloodstream to plummet. It interferes with REM (rapid eye movement) dream sleep. It leads to daytime drowsiness, and also to high blood pressure [2]. As the heart struggles to circulation poorly oxygenated blood to the brain during sleep, the stage is set for a long list of cardiovascular complications including congestive heart failure, atrial fibrillation, nocturnal arrhythmias, stroke, pulmonary hypertension, and atherosclerosis [3].

What accelerates inflammation?

Low oxygen levels favor the production of free radicals that accelerate inflammation [4]. Obesity makes the level of inflammation even worse [5], while at the same time obesity itself is a risk factor for even more sleep apnea [6]. The one-two punch of sleep apnea that aggravates obesity and obesity that aggravates the sleep apnea syndrome sets the stage for a number of familiar diseases:

  • Sleep apnea and obesity place severe stress on the right side of the heart. People who have both conditions are likely to develop problems with the right coronary artery. Atherosclerotic cholesterol plaque builds up close to the heart, because the heart is working very hard to get blood to the lungs to pick up oxygen between apnea episodes. [7] People who have this condition may have heart attacks over and over again, which the doctors treat with stents in the same place over and over again. Until the sleep apnea is treated, the stents will never work.
  • Sleep apnea worsens type 2 diabetes by increasing insulin resistance [8]. Oxygen levels go down and back up again over and over each night. Cells burn more glucose when oxygen levels are higher, but they can't burn glucose when oxygen levels are lower. High glucose levels inside a cell cause damage to DNA, so cell turn off the receptor sites for insulin. These receptor sites can't be turned back on later.
  • Insulin resistance in turn also aggravates obesity, cholesterol, blood pressure, and triglyceride levels.
  • When oxygen levels go down, the bloodstream redirects blood to the brain. Over a period of years this pressure can cause atherosclerosis in the internal carotid artery. [9] In old age, this can lead to vascular dementia, but even before that, there can be a condition called amaurosis fugax. Even during the day, so little oxygen can reach the brain that tiny specks of vision are lost. People who have the condition say it's a little like trying to look through a sieve, black spots over a normal field of vision, but not due to damage to the retina.
  • The chemistry of the blood changes. The blood making cells in bone marrow work harder to create high hemoglobin levels and a high red blood cell count.
  • The combination of obesity and sleep apnea increases the risk of fatty liver disease [10].
And if all of that wasn't bad enough, people who have sleep apnea are up to nearly five times as likely to have auto crashes, probably because they fall asleep at the wheel [11].

If all this sounds like a terrible fate for someone who just "snores," it is. When snoring is due to sleep apnea, it can lead to an ever-growing number of hard-to-manage disease conditions. You're tired all the time, so you don't exercise. You don't exercise, and you gain weight. You get type 2 diabetes, and you feel even worse. You start needing to take naps to get through the day, or you go to work in a haze. Your disease affects your job. Your job, in the United States, at least, affects your ability to get health insurance.

You may find you can't afford the $5,000 to $10,000 for a sleep study to confirm that you have sleep apnea, and you can't afford about $1,000 for a CPAP (continuous positive airway pressure) machine to treat it, either. But if you don't have the sleep study, you don't get the CPAP machine (in most cases).

How to find a way to get a sleep study and appropriate treatment?

What can you possibly do to know whether you need to find a way to get a sleep study and appropriate treatment, like CPAP, to prevent a series of health problems in your forties, fifties, and sixties? It turns out that your doctor is probably already giving you the test that points you in the right direction.

Every complete blood count measures hemoglobin (the protein that carries oxygen) and red blood cell count (the number of red blood cells in your blood). If: 

1. you know you snore or have some other sleep breathing problem and

2. your have high hemoglobin levels and a higher than normal red blood cell count,

then it's highly likely you also have obstructive sleep apnea. Your body is working hard to compensate for it in many ways, but blood is easy to test.

Or at the very least the test costs maybe $20, rather than $10,000. Ask your doctor about your blood test results. And get sleep apnea treated as soon as you can.

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