When the Los Angeles coroner’s court reported sleep apnea as a part cause of the death of the actress Carrie Fisher, many people may have previously been unaware of the condition.
Yet it is estimated 22 million Americans may suffer with this sleep disorder, with the vast majority remaining undiagnosed. In acknowledging the impact of this sleep disorder in Carrie Fisher’s death, the coroner has brought to the attention of the public the serious impact it can have on a sufferer’s health and how it can ultimately be fatal.
Carrie Fisher suffered a heart attack while on a flight between London and Los Angeles and passed away in hospital four days later. It was not reported whether the actress was aware she had the sleep disorder, though her assistant noted she had experienced respiratory events or apneas while she slept on the plane.
The coroner also noted other undetermined factors, as well as atherosclerotic heart disease and drug use as contributing to her death.
In listing obstructive sleep apnea (OSA), the most common form of the sleep disorder, as part cause of Carrie Fisher’s death the coroner has emphasised the potentially fatal impact of OSA when left untreated.
OSA and Its Impact on Health
People with OSA will experience interruptions to their sleep due to a narrowing of their airways, prompting the brain to wake the body for air. The frequency of the interruptions, or apneas, will depend on the severity of an individual’s OSA.
One reason it may remain undiagnosed is that the main symptoms, such as heavy snoring and sudden awaking to breathe, occur when sleeping and will often only be first noticed by a partner. Sufferers can experience fatigue, poor concentration levels, increased irritability, morning headaches and a dry throat.
However, without a diagnosis and treatment OSA can lead to serious health issues.
Although it may be argued OSA does not directly cause a person’s death, research indicates it can be a major contributing factor. In the case of Carrie Fisher, her untimely death was from a heart attack, of which OSA is known to put people at an increased risk.
A study conducted at Yale University suggests people who have OSA for five years or more are 30% more at risk from a heart attack. Indeed, research consistently points to an increased risk of serious health complications for sufferers of OSA.
A University of Wisconsin-Madison study in 2008 concluded sufferers with severe and untreated OSA have 3 times the risk of death compared to those without the disorder.
Why OSA Can Be Deadly
OSA has been linked to an increased risk of a number of serious health conditions including:
- Heart disease
- High blood pressure
- Type 2 diabetes
One of the major effects of OSA is the interruption to sleep, which can happen numerous times every night in more severe cases.
Sleep plays a vital restorative role in allowing the body to recover from the strains placed on it through the day. When the body does not get the sleep it needs it has extra stress placed on it. Sleep deprivation affects the immune system as well as leading to higher blood pressure with lack of sleep leading to increased hormone production.
Heart Disease Contributes
Carrie Fisher died following a heart attack in which OSA was a contributing factor. Heart disease is known to be the largest cause of death of any illness or condition and 6% of these mortalities have been shown to have had OSA too.
When the airways narrow or get blocked due to sleep apnea, it leads to a drop in blood oxygen levels -- with the brain responding by waking the person up, sometimes gasping for air.
This disruption to the amount of oxygen being taken in makes it more difficult for the brain to assess blood flow. The additional stress can result in the heart having to work harder to cope as blood pressure levels rise. Researchers also think OSA can be linked to abnormal heart rhythms which may lead to sudden cardiac arrest.
The Los Angeles coroner reported Carrie Fisher as having atherosclerotic heart disease, signified by a hardening of the arteries in the heart due to substances like cholesterol and fats.
This type of heart disease affects the ability to efficiently move blood through the heart, leading to a potentially fatal poor blood flow. Those who also have OSA will find their heart muscles further compromised by the lack of oxygen placing additional stress on this major organ.
Diagnosis and Treatment for OSA
Although OSA can lead to serious health consequences, treatment of the disorder can reduce the symptoms and also reduce the risk of these health issues.
For successful treatment, a diagnosis is crucial and it is a lack of awareness of the symptoms and a lack of diagnosis which means so many will be living unaware they have OSA.
Once you suspect you may have this debilitating sleep disorder, where heavy snoring and frequent interruptions to sleep are major symptoms, a simple in-home test can be obtained. From the comfort of your own home a monitor will record blood oxygen levels and heart rate as you sleep over a couple of nights, with the subsequent data examined by trained sleep specialists.
OSA Risk Factors
Anyone can suffer from OSA -- but being overweight places people more at risk. Once a diagnosis of OSA has been made lifestyle changes such as improved diet, more exercise, no tobacco and reduced alcohol consumption may be recommended to try and counter the symptoms.
If lifestyle changes are not enough to reverse the symptoms alone one of the leading treatments for OSA is continuous positive airway pressure (CPAP) therapy.
This involves a device to supply a steady stream of air through a mask worn overnight in order to keep the airways open as you breathe to prevent the interruptions to sleep associated with OSA. Previous research has suggested that the increase in risk of death from OSA increases with the severity of the disorder. However, successful treatment using options such as CPAP therapy can reduce this risk.
Further Dangers of Undiagnosed OSA
Sleep deprivation and insomnia are hugely debilitating and can affect both your physical and mental health. Unspecified drug use was another contributing factor stated by the coroner in Carrie Fisher’s death -- and this may have been due to her being unaware she had OSA.
As well as causing mood disorders and depression, OSA sufferers who have not been diagnosed may turn to substances to try and counter their lack of sleep and subsequent fatigue. Another effect of fatigue which makes diagnosis and treatment so crucial is the increased risk of accidents, in particular traffic accidents, through sleep deprivation.
Too many people will be suffering a lack of sleep and the heath issues this can bring through lack of awareness of OSA. Other well-known stars who have died from health issues related to this sleep disorder include James Gandolfini, John Candy and Jerry Garcia.
By stating OSA as a major cause in the death of Carrie Fisher the coroner may have raised awareness of this sleep disorder and mean more people getting tested and treated for their sleep deprivation.
Do you have sleep apnea? Take this quiz: https://www.sleepquest.com/sleep-apnea-questionnaire/