APAP and Arthritis: Could APAP Benefit Arthritis Patients?
The pain and discomfort caused by arthritis can make falling asleep and staying asleep more difficult. Indeed, it is estimated that up to 80% of arthritis sufferers report trouble sleeping and daytime fatigue.
However, excessive daytime fatigue is also a primary symptom of sleep apnea, a disorder that can lead to significant sleep deprivation. Increasingly, research suggests a possible connection between the two conditions, and treating one could help ease the symptoms of the other.
This holds out the prospect of using a positive airway pressure device such as APAP for arthritis to improve sleep quality and potentially reduce the symptoms of arthritis too.
The Connection Between Sleep Apnea and Arthritis
A 2016 study published in the journal BMJ Open reported a 75% increased likelihood of those with rheumatoid arthritis also having obstructive sleep apnea.
Rheumatoid arthritis is an autoimmune disease that largely affects the joints. It is characterized by inflammation of the joints that can be extremely painful. The pain can prevent quality sleep, leading to a vicious cycle, as people often report they are in more pain following a poor night’s sleep.
Although the connection to sleep apnea is still uncertain, a common theme between the two conditions is inflammation.
The frequent breathing pauses caused by sleep apnea cause reduced oxygen levels in the blood, known as hypoxia. It can also cause oxidative stress. Hypoxia and oxidative stress can both result in inflammation that could exacerbate the symptoms of arthritis.
Weight is another factor that seems to connect the two conditions. Obesity is a major contributing risk factor for obstructive sleep apnea, with excess fat tissue in the neck collapsing into the throat when the muscles relax during sleep to create an obstruction.
Obesity can lead to an increased risk of inflammation by producing pro-inflammatory cytokines. This increased inflammation can contribute to someone’s arthritis.
While further research is required, the potential connection between the two conditions suggests that managing sleep apnea may help manage your arthritis symptoms. For example, your healthcare provider may prescribe APAP to treat sleep apnea, and there could be subsequent benefits of APAP for arthritis.
Diagnosing Sleep Apnea
Up to 85% of obstructive sleep apnea cases go undiagnosed. This is a significant issue considering that sleep apnea, when left untreated, increases the risk of heart disease, stroke, and diabetes.
As arthritis can negatively impact sleep, fatigue is often viewed as a symptom of the condition. An underlying sleep disorder like sleep apnea can be missed. However, the increasing appreciation of a potential connection between arthritis and sleep apnea means sleep apnea is more likely to be considered now.
Sleep apnea presents further symptoms such as waking gasping for air, loud snoring, and a dry mouth in the morning. If your healthcare provider is aware of these additional symptoms, they may recommend a sleep study.
Home sleep testing is now the preferred method of diagnosis of sleep apnea and is covered by insurance companies. Patients prefer to sleep in their own bed and the technology and accuracy has advanced considerably through the years. Alternatively, one could have an overnight stay at a sleep clinic where your sleep is monitored and data including sleep patterns, respiratory episodes, heart rate, and blood/oxygen levels are recorded.
Following a sleep apnea diagnosis, your healthcare provider will work with you to recommend the most suitable treatment. For mild sleep apnea where weight is the main contributing factor, lifestyle changes aimed at weight loss may be the recommended protocol.
For moderate to severe cases of sleep apnea, continuous positive airway pressure (CPAP) is a common treatment device. CPAP delivers pressurized air through a mask worn overnight to help keep the airways free from obstruction. However, not everyone can tolerate the fixed air pressure setting of CPAP. In this instance, APAP may be recommended as an alternative device.
What Is APAP?
APAP stands for automatic positive airway pressure. Instead of a fixed pressure, APAP adjusts the air pressure according to your breathing patterns. CPAP can be difficult to tolerate when exhaling against a fixed pressure. APAP increases the pressure setting when it detects breathing is slowing, before reducing the pressure when breathing returns to normal.
PAP devices are effective at managing sleep apnea and reducing the symptoms of the disorder. This helps improve the quality of sleep as there are fewer interruptions from breathing pauses.
Good quality sleep may be something that regularly evades an arthritis sufferer. However, if there is a connection between sleep apnea and arthritis, then there could also be benefits from APAP for arthritis patients.
Could APAP Ease Arthritis Symptoms?
An increase in pain from arthritis is often reported following a poor night’s sleep. As with sleep apnea, sleep deprivation from arthritic pain could result in an increase in inflammatory markers in the body. There is also the psychological aspect to consider, where a lack of sleep worsens your mood and concentrates your thoughts more on your joint pain.
This is heightened if you also have sleep apnea. Using APAP to manage your sleep apnea helps improve the quality of your sleep. This in turn could reduce the level of inflammation in the body caused by sleep deprivation, providing a level of relief in the symptoms of arthritis.
The benefits of APAP for arthritis and sleep apnea have the potential to be significant by addressing the inflammatory impact of sleep deprivation, hypoxia, and oxidative stress.
Tips for Better Sleep
As better quality sleep can help manage sleep apnea and arthritis symptoms, practicing good sleep hygiene is also important. Tips to help you fall asleep and stay asleep include:
- Keeping to a regular bedtime schedule, going to bed and getting up at the same time each day
- Avoiding alcohol and smoking
- Regular exercise, although not too close to bed
- Relaxation methods before bed including reading, meditation, or a warm bath
- No screens in the bedroom
- Ensuring a comfortable bedroom temperature
Poor sleep is associated with flare-ups in arthritic pain, while arthritic pain can worsen sleep apnea through poor sleep. Research indicates a potential connection between sleep apnea and arthritis with inflammation as a possible link. Therefore, by managing sleep apnea with APAP, you could find benefits from APAP for arthritis through improved sleep.