Sleep Apnea and Liver Disease: Obese Adolescents at Risk
Sleep disorders like sleep apnea are dangerous if left untreated. New studies suggest that the risks to those who develop the disorder are becoming greater and greater every day. One such study, reported in the “Journal of Hepatology,” suggests that obstructive sleep apnea (OSA) contributes a great deal to non-alcoholic fatty liver disease (NAFLD) in adults and children.
What Is NAFLD?
Non-alcoholic fatty liver disease (NAFLD) is a condition where fat builds up in the liver. This may be due to a resistance to insulin and a metabolic syndrome. This disorder usually shows up in a high percentage of those with obesity. This is a liver disease that is not caused by alcohol, hence the name.
It is unhealthy to have too much fat stored in the liver. This causes the liver to swell up, scarring is developed, and can lead to liver cancer or failure. There aren’t that many symptoms with NAFLD. Typically the disorder causes the following:
- Spider-like blood vessels
- Ascites (abdominal swelling)
- Abdominal discomfort.
How Sleep Apnea Causes Liver Disease
Due to low levels of oxygen during sleep, many patients with sleep apnea develop oxidative stress, which means that their body has trouble detoxifying the harmful effects of free radicals. This can speed up the progression of NAFLD, and eventually lead to a worst disease called non-alcoholic steatohepatitis (NASH).
Lead investigator Shikha Sundaram, MD, MSCI, of the Children’s Hospital Colorado, University of Colorado School of Medicine stated, “According to recent reports, pediatric NAFLD patients with OSA/hypoxia have more advanced liver disease and fibrosis, supporting a role for OSA/hypoxia in the development of NASH. However, the mechanisms underlying this relationship have not yet been explained.”
The disease affects 30% of the general population in Western countries, and about 9.6% of all children. With the growing issue of obesity, this condition could potentially affect more people every year.
The researcher’s findings showed that patients with severe liver disease also had a serious case of OSA. They hope that correlation between the two conditions will lead to finding a way to treat patients. “We definitely need trials designed to investigate whether CPAP treatment may significantly affect NAFLD progression in this age range. The only randomized controlled trial was of relatively short duration, performed on adult patients with mild OSA/hypoxia and normal baseline transaminases, and apparently did not demonstrate any impact on steatosis, NASH or liver fibrosis,” says Dr. Sundaram.