Among the serious health effects of sleep apnea, high blood pressure is one of the most common. It’s so common that it’s considered a warning symptom of sleep apnea, and is used in diagnostic and screening tests, such as the STOP-BANG questionnaire. Unfortunately, high blood pressure also increases the risk of even more serious complications such as heart failure and stroke. High blood pressure stresses the heart, and it makes it more likely that arterial plaque will break off and become lodged in the brain, causing a stroke. It can also contribute to serious health problems like kidney disease that develop from the stress of high blood pressure.
High blood pressure related to sleep apnea resists traditional treatments. Researchers are trying to detect the exact mechanism that links sleep apnea and elevated blood pressure so that they can find a new treatment that might help people with sleep apnea find relief from their high blood pressure. By pinpointing the exact link between sleep apnea and high blood pressure, researchers have identified a new potential for treatment.
Oxygen Sensing and Constricted Blood Vessels
The process that increases blood pressure in sleep apnea begins in the carotid body. The carotid body is like the body’s oxygen sensor. It detects when the blood oxygen content is low and triggers many responses to try to increase the blood oxygen levels.
Among the responses of the carotid body is the generation of reactive oxygen compounds, part of the normal metabolism of oxygen in the body. As a result, enzymes in the body change the way they use oxygen. They stop producing carbon monoxide and start producing hydrogen sulfide. The hydrogen sulfide then triggers the blood vessels in the body to constrict. This decreases the volume of the blood vessels and increases the pressure.
The goal, then, is to find something that blocks the production of hydrogen sulfide.
An Enzyme Blockade
Researchers believe they have identified a possible treatment. An enzyme inhibitor L-propargylglycine (L-PAG) was found to restore normal function and prevent the development of hydrogen sulfide that resulted in high blood pressure. They tested this inhibitor in mice that were exposed to simulated apneas (brief periods of oxygen deprivation), and found that it prevented the constriction of blood vessels and the resulting increase in blood pressure. They say that this might be a good treatment for this effect of sleep apnea.
Do We Need a Sleep Apnea Drug?
Although there are many companies that would be happy to develop a sleep apnea drug, previous attempts to develop sleep apnea drugs have failed. And while this is a promising treatment for one small part of the sleep apnea health problem, it would still leave other problems, like mental health issues, untreated.
The primary drive behind efforts to develop a sleep apnea drug (other than profit) is to find a more comfortable, convenient treatment option than CPAP. This kind of thinking is stuck in the days when CPAP was the only proven treatment for sleep apnea. Today, though, oral appliances offer a comfortable, convenient alternative to CPAP. And they are very effective at providing relief from the many health effects of sleep apnea. In fact, oral appliances are as effective as CPAP for reducing high blood pressure.
So if you are looking for a comfortable alternative to CPAP, you don’t have to wait on the development of sleep apnea drugs. All you have to do is look for a sleep dentist who can fit you with an oral appliance.