Obstructive sleep apnea and respiratory compromise: Know your risk

(BPT) – Obstructive sleep apnea (OSA) — a potentially serious sleep disorder that can stop a person’s breathing during sleep — affects 25 million adults in the U.S. Individuals living with OSA may know they are at risk for high blood pressure, stroke, heart attack, diabetes or headaches. What they may not know is that OSA is also a risk factor for respiratory compromise, a potentially fatal condition.

Respiratory compromise is the second leading avoidable patient safety issue and can occur during hospitalization when a patient is recovering from a surgery or during an outpatient procedure using anesthesia. Although relatively unknown, respiratory compromise can cause an individual’s breathing to weaken, potentially leading to respiratory failure and even death. OSA is just one of several conditions that increase a person’s risk for respiratory compromise; age, obesity and chronic obstructive pulmonary disease are other risk factors.

Although respiratory compromise is a serious health issue, it is frequently preventable. By using appropriate therapies and patient monitoring technologies to evaluate a patient’s respiratory status, healthcare professionals can detect respiratory compromise and treat patients earlier.

“OSA sufferers must understand that their condition not only impacts their sleep and overall health. They need to be aware that it may increase their risk for respiratory compromise. Signs of respiratory compromise include apneas or stop-breathing episodes and changes in consciousness and alertness, among others,” said Dr. Peter C. Gay, a sleep medicine specialist. “If you have OSA and need to undergo a medical or surgical procedure, speak with your healthcare provider about respiratory compromise. It can be detected early with appropriate respiratory monitoring technologies.”

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* C-reactive protein (CRP) is a protein produced by the liver and found in the blood. The level of CRP rises when the body suffers inflammation.

The American Heart Association categorizes the levels of CRP as follows:

Low hs-CRP – less than 1.0 mg/L
Moderate hs-CRP – between 1.0 mg/L – 3.0 mg/L
High hs-CRP – higher than 3.0 mg/L
Inflammation, in itself, is not a serious problem. Typically, it occurs in response to trauma, illness or infection. In such cases, inflammation may manifest in various forms, such as hives, rashes, a sprained ankle or a sore throat.

However, inflammation that persists is a great cause for concern and can be indicative of serious disorders.

A CRP test is a simple blood test that could measure your body’s inflammation level based on the level of CRP in your blood.

This information could be crucial to identifying a hidden health risk that standard, and even specialized, checkups often miss. Several studies have found that abnormal CRP levels can be an early warning sign of trouble.

Heart Disease, Attacks & Strokes

While an abnormal CRP level alone is not indicative of heart disease risk, when combined with increased low-density lipoprotein (LDL or ‘bad’ cholesterol), blood pressure, blood sugar and triglycerides, it definitely calls for immediate medical attention.

In fact, an abnormal CRP level may identify a person at high risk of a first heart-associated event (disease, attack or stroke) that may not present itself during a regular lipid checkup, according to a 2005 study published in The Journal of the American Osteopathic Association.

A 2002 study published in Diabetes Care found that increased body mass index (BMI), uric acid and blood glucose were positively associated with increased CRP levels and body inflammation.

All the above mentioned conditions are increasingly high-risk factors for heart disease, attacks and strokes.

It is common knowledge, nowadays, that heart disease is directly linked to increased trans-fat intake through foods like processed bakery goods, shortening-based desserts and margarine, among others.

CRP levels were significantly higher in subjects who consumed a high trans-fat diet as compared to those who did not, according to a 2005 study published in the Journal of Nutrition.

CRP levels are also a moderate indicator of coronary heart disease (CHD), according to a 2004 study published in The New England Journal of Medicine. CHD is a disorder in which the arteries are blocked, obstructing the flow of oxygen-rich blood to the heart and brain, usually resulting in a heart attack or stroke.

According to the American Association for Clinical Chemistry, low but persistent levels of CRP are an indication of arterial blockage that may develop into CHD.

A CRP blood test will be able to identify such a cardiovascular development.

The best way to determine a future cardiovascular risk is to get a CRP blood test done – preferably a high-sensitivity C-reactive protein (hs-CRP) test – along with a lipid profile test.


A high CRP level and increased inflammation are also associated with Type 2 diabetes – another risk factor for heart disease.

Out of 188 subjects who would go on to develop Type 2 diabetes in a follow-up period of four years, 15.7 percent reported high levels of CRP, according to a 2001 study published in The Journal of the American Medical Association.


Persistent, long-term inflammation of body organs may drive them toward cancer, according to a 2006 study published in Molecular Cancer Research.

While an elevated CRP level is by no means concrete proof of cancer, it is a crucial indicator that could direct a high-risk individual toward diagnosis.

For example, a 2004 study published in The Journal of American Medical Association found that CRP levels were at their highest in subjects who went on to develop colon cancer in the future.

Rheumatoid Arthritis

A CRP blood test could be useful in successfully predicting the early progression of rheumatoid arthritis (RA), an inflammatory autoimmune disease.

The CRP blood test was identified as one of the key tests involved in evaluating the progression of RA in patients in order to successfully determine who will require the strongest medication therapy in the future, according to a 2000 study published in Rheumatology Oxford.

Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a sleep disorder caused by an obstruction in the upper respiratory tract that prevents normal breathing.

It is typically (but not always) caused by obesity, is indicative of body inflammation and is a high-risk factor for heart disease.

An increased CRP level can be an indicator of OSA.

Blood CRP levels were found to be significantly higher in study subjects who had recently developed OSA than in those who had not, according to a 2002 study published in Circulation.

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