Is Obstructive Sleep Apnea Genetic?

Genetic factors are linked to many illnesses, from a predisposition to certain types of cancer to a tendency for high blood pressure. If you have ‘blood relatives’ who have Obstructive Sleep Apnea (OSA) you may wonder if due to hereditary factors, will you develop it too? 

“My father snored when I was a kid, and now I do too. Did I get it from him?” 

Genetic refers to being controlled by your genes, heredity means inherited. While they are often considered to be the same, there are differences. Cancer is a genetic disease (involving the genes) but not necessarily inherited. Obstructive Sleep Apnea is complex. 

Every cell carries genetic material (genes) and amazingly, each cell carries its own sleep ‘time clock’ with which it communicates with its neighbours. It is now believed that Obstructive Sleep Apnea does carry a genetic predisposition. That is, it can be inherited by about 40%, because the other 60% percent of underlying causes for Obstructive Sleep Apnea are environmental or lifestyle related.  

So, the more relatives you have with Obstructive Sleep Apnea, the higher risk you have of developing it. Equally if you’ve inherited certain jaw anatomy, you may mouth breathe as a child which causes developmental changes which also increases your likelihood of developing it too. 

Equally, it is definitely true that as weight increases, so does the incidence of Obstructive Sleep Apnea, which is why we’re on the brink of an unrecognized epidemic which will burden the medical system enormously by causing diseases such as high blood pressure, heart attack, stroke and type 2 diabetes. It will shorten the lives and decrease the quality of life for millions. 

Smoking, a lack of sleep and excessive alcohol consumption are also bad lifestyle choices. Alas, just as in weight loss, these are not always quite as easy as they sound to control.  

Central Sleep Apnea and Obstructive Sleep Apnea 

Central Sleep Apnea and Obstructive Sleep Apnea both have hereditary factors, so let us look at what Central Sleep Apnea and what Obstructive Sleep Apnea is. 

Central Sleep Apnea is due to neurological issues that cause your brain to send the wrong signals to the muscle groups that control your breathing, causing it to stop periodically. It’s like the brain forgets to tell you to breathe. 

Obstructive Sleep Apnea is a mechanical issue where the tongue falls back into the airway blocking the airway. When complete blockage occurs, it’s called and apnea and when a partial closure occurs, a hypopnea. Partial closure is often associated with snoring. 

Sometimes, muscles located in the back of the throat become too relaxed even in young, slim and fit men and women. The airway collapses more easily and can also block your airway, either partially or completely. This is referred to as Upper Airway Resistance Syndrome (UARS) and often misdiagnosed, as the subject does not seem a typical Obstructive Sleep Apnea candidate. 

Mixed Sleep Apnea 

Mixed Sleep Apnea is a mix of Central and Obstructive Sleep Apnea where each of these different types of sleep apnea carry genetic factors. However, there is less evidence supporting that Central Sleep Apnea is hereditary, aside from certain heart-related conditions. 

In the case of Obstructive Sleep Apnea, there is far more research that points to it having genetic factors, with it being about 40% hereditary. As Obstructive Sleep Apnea is also the more common type, we can focus on its hereditary factors.  

Factors that contribute to Inherited Obstructive Sleep Apnea 

There are several factors that you can inherit that can contribute to the development of Obstructive Sleep Apnea too: 

Large tonsils – Often, when one parent is born with large tonsils, that trait will show up in their children. Large tonsils are one of the significant contributors to childhood Obstructive Sleep Apnea. Environmental conditions and disease can of course also cause or worsen this too. 

Obesity – The genetic impact of obesity can range from 25% to as high as 80%, according to some studies. If you have one or more parents and blood relatives that are obese, your genetic predisposition to obesity is high, as well as the often-accompanying sleep apnea, which may often result in high blood pressure and some of the other diseases associated with Obstructive Sleep Apnea.  

Hyperthyroidism – Both non-autoimmune and autoimmune hyperthyroidism have hereditary links, often directly inherited from a parent. Due to enlargement of the tongue (macroglossia) or disruption of the muscles that control the upper airway, hyperthyroidism may lead to sleep apnea that requires separate management from hyperthyroidism.  

Thicker Neck – If one or more parents have a thick neck, it is more likely that you will inherit this trait, particularly if you are male. Having more mass around your neck can lead to Obstructive Sleep Apnea, as it puts more pressure on your neck muscles and airway. This risk is increased in women and men whose neck circumference exceeds 16” and 17” respectively. This is also true of athletes who have little fat but thick muscular necks. 

Small Lower Jaw – A small lower jaw is a risk factor due to oral volume and tongue position.  

Nasal Congestion – Nasal congestion is a risk factor whether it is triggered by inherited allergies or hereditary enlarged adenoids. Those who have nasal congestion are also more at risk of developing Sleep Apnea.  

Early testing is essential to treat and manage Sleep Apnea and prevent its associated diseases. 

If you recognize any of the above hereditary Sleep Apnea risk factors and find yourself suffering from excessive daytime sleepiness or a lack of energy, then it is essential that you get yourself tested for Sleep Apnea.  

Tiredness is by no means the only sign, but a not uncommon one. 

Other signs and symptoms include reported heavy snoring, breath holding, gasping for air while asleep, morning headache and difficulty in concentrating or a deteriorating memory. The sooner your Obstructive Sleep Apnea is identified, the sooner you can protect yourself from the dangerous side-effects of untreated sleep apnea.   

If you have any concerns that you may have Obstructive Sleep Apnea, you can call us for screening and assistance in resolving this so that you can get on with your life, the way it was meant to be!  

How did we get ourselves in this shocking state of ignorance and apathy? 

A good question. Certainly, physicians are not provided adequate education in Sleep Medicine as undergraduates. Studies show this on average to be a few hours at best. Dentists usually get less. Our culture generally dictates that we assume that someone else will ‘look after our health’ for us, please do not shoot the messenger, but I have found this to be true. 

If this were an irritating or inconvenient disease, reluctance to pay for care would be easier to understand. 

Governments are reluctant to provide funds for direct patient medical care, except when there are beneficial appearances. Many studies have shown the enormous savings and decreased burden on Healthcare Systems but Governments cannot be seen to invest in long-term health care benefits which will show savings later. I spoke to the BC Health Minister 4-5 years ago and was told that the Government was, “looking into it.” 

The Government of Ontario provide CPAP but not Dental Oral Appliances despite poorer compliance of CPAP (than Oral Appliance Therapy). A recent paper from the University of British Columbia, outlining the savings which would be achieved by funding Dental Oral Appliances was sent a few years ago to that Government. Upon speaking to the UBC professor who sent it, she told me they she had not yet received a response. 

Takeaway  

Obstructive Sleep Apnea is closely linked to several life-threatening conditions. It may cause or worsen chronic illnesses like high blood pressure. Sleep Apnea can lead to sudden cardiac death.  

If you have a history of stroke, heart disease, atrial fibrillation diabetes, or another chronic illness, ask your doctor to test you for Sleep Apnea too. Treatment may include getting diagnosed at a sleep clinic and wearing a dental Oral Appliance or even a CPAP mask at night, but the benefits far outweigh the disadvantages. 

Treating your Sleep Apnea will improve your quality of life and may even help save your life regardless of whether your disease is inherited or not. 

If you have any concerns that you may have Obstructive Sleep Apnea, you can call us for screening and assistance in resolving this so that you can get on with your life, the way it was meant to be!  

For more Blogs - please see - www.abettersleep.net - Stephen Bray (2020)