Sleep apnea is a condition characterized by interrupted breathing during sleep, leading to frequent awakenings and reduction in sleep quality. Consistent sleep interruptions can harm physical health, weakening the immune system and increasing vulnerability to illnesses.
In an exclusive interview with Zee News English, Dr Randeep Guleria, Chairman, Institute of Internal Medicine & Respiratory and Sleep Medicine at Medanta, and Former Director & CEO, AIIMS, New Delhi talks about the growing link between sleep apnea and non-alcoholic fatty liver disease i.e. how your sleep can affect your liver health.
Connection Between Sleep Apnea and Non-Alcoholic Fatty Liver Disease
“In addition to its adverse effects on overall health, sleep apnea can also contribute to the development of Non-alcoholic fatty liver disease (NAFLD), a condition commonly observed in overweight or obese individuals. Excess weight can contribute to Obstructive sleep apnea (OSA) by narrowing the airway, while also promoting insulin resistance and fat deposition in the liver, exacerbating fatty liver disease,” says Dr Guleria.
According to a report, “OSA is associated with an increase in liver enzyme concentrations in 35% of obese individuals. This connection highlights the importance of addressing obesity through lifestyle changes and medical interventions to improve both sleep and liver health,” quotes Dr Guleria.
Impact of Sleep Apnea on Physical Health
“With the frenetic lifestyles that people have today, health has taken a backseat for many due to paucity of time, leading to lifestyle diseases such as obesity.”
Dr Randeep Guleria comments, “The typical approach to treat patients with Non-alcoholic fatty liver disease and Obstructive sleep apnea has centered on addressing concurrent conditions such as obesity, diabetes mellitus, hyperlipemia and cardiovascular disease. Weight loss has demonstrated its effectiveness in enhancing insulin sensitivity, and in some instances, it has led to the resolution of nonalcoholic steatohepatitis (NASH).”
“Moreover, insulin resistance (IR) emerges as a common denominator in many cases of Non-alcoholic fatty liver disease and Obstructive sleep apnea.”
4 Ways Sleep Apnea and Non-Alcoholic Fatty Liver Disease can be managed
Let’s look at some of the approaches that Dr Randeep Guleria has shared which have been advocated for managing both Obstructive sleep apnea and Non-alcoholic fatty liver disease simultaneously:
Lifestyle adjustments and weight reduction
When it comes to managing OSA and NAFLD, lifestyle interventions should be the first line of treatment. A key component of managing NAFLD is adopting a balanced, low-fat diet, incorporating regular exercise to the schedule, and reducing the intake of saturated and trans fats.
Continuous positive airway pressure (CPAP) therapy
For individuals suffering from both Non-alcoholic fatty liver disease and Obstructive sleep apnea, CPAP therapy is a valuable treatment. The CPAP machine sends air under pressure through the tube into the mask, where it imparts positive pressure to the upper airways. This essentially acts as “splints” and keeps the upper airways open and prevents them from collapsing. It is also helpful in reducing elevated biochemical and liver enzyme levels in people with both Non-alcoholic fatty liver disease and Obstructive sleep apnea.
Insulin Sensitizer drug
In cases where lifestyle changes and CPAP therapy are insufficient, other treatment modalities may be considered. One such option can be an insulin sensitizer drug which aims to enhance the body’s response to insulin, thereby reducing blood sugar levels and potentially mitigating the impact of insulin resistance on NAFLD.
Bariatric surgery
Bariatric surgery, primarily used for morbidly obese patients, can also improve conditions associated with Obstructive sleep apnea (OSA) and Non-alcoholic fatty liver disease (NAFLD). This treatment option can be an alternative for severe and complicated obesity.
“The effectiveness, performance and general health of a person can all be enhanced by getting adequate sleep. The easiest approach to determine whether you are getting enough sleep is by feeling refreshed when you wake up,” concludes Dr Randeep Guleria.