Sleep Apnoea, Inflammation and Omega-3-Fatty Acids

Obstructive sleep disorder is a breathing disorder during sleep wherein there are breathing pauses and reduced ventilation during sleep. There are a lot of risk factors for this medical disorder, including excess body weight, male gender, older age, neck circumference, body mass index, and high blood pressure. This disorder is not at all harmless; it is often linked to an increased risk of cardiovascular mortality and morbidity. It can lead to other deadly diseases such as hypertension, stroke, myocardial ischemia, and arrhythmias with an increased risk for sudden cardiac death.  

So why does this happen? According to experts there are many mechanisms behind this. Animal models and cell cultures often suggest that inflammatory mediators such as tumour necrosis factor may lead to cardiovascular mortality. TNF-α is regarded as an endotoxin induced glycoprotein that can cause hemorrhagic necrosis of sarcomas. It is often produced by white blood cells such as monocytes and macrophages during inflammation. There are recent studies which say that TNF-α can lead to cardiovascular complications in patients with obstructive sleep apnoea. Other studies have demonstrated that continuous positive airway pressure (CPAP) therapy decreased the TNF-α level in OSA patients.

Aside from CPAP, studies have been concentrating on other means that can decrease TNF levels in patients with obstructive sleep apnoea. A possible alternative therapy is nutritional immunology, which may be in the form of supplementation with omega-3 fatty acids (omega-3 FAs).

Omega-3 fatty acids are essential fatty acids that must be taken up into the body through food. These essential fatty acids are needed by the body for it to function normally. It is said that omega-3 fatty acids have a lot of healthy benefits such as reducing inflammation in blood vessels and joints. The two main types of omega-3 fatty acids are EPA and DHA. These are found in certain fish. Flax and other plants may also contain a type of fatty acid known as ALA, an omega-3 fatty acid that is partially converted into DHA and EPA in the body. Algae oil often provides only DHA.

Since the early times, omega-3 fatty acids have been known to have various benefits on the cardiovascular system. It is said that omega-3 fatty acids can help prevent coronary heart disease, reduce arrhythmias and thrombosis, lower plasma triglyceride levels, and reduce blood clotting.

Also, it is a known fact that chronic inflammation is a characteristic of severe chronic heart failure (CHF), and inflammatory cytokines have been shown to reduce left ventricular (LV) function, promote LV remodelling, and deteriorate endothelial function. Thus, with supplementation of omega-3 fatty acids, there is improvement of systolic LV function and endothelial function as well as decreases in the markers of inflammation in CHF of non-ischemic origin and other clinical conditions. Thus it may be that omega-3 fatty acids may have the capability of improving cardiac function in individuals with OSA.

In addition to all these benefits, omega-3 fatty acids are known to be safe, well tolerated and with minimal side effects. Seafood (commonly found in fish and fish oil) is the only food that provides large amounts of omega-3 FAs. The best seafood choices are wild salmon, anchovies, sardines, trout, herring, and tuna. As a matter of fact, international guidelines have suggested that the general population should consume at least 250mg/day of long-chain omega-3 FAs or at least two servings/week of oily fish.

More studies should be done to know the other benefits of omega-3 fatty acids on patients with obstructive sleep apnoea. Meanwhile, you can try it as long as your doctor recommends it for you.

Reference:

Scorza FA1, Cavalheiro EA1, Scorza CA1, Galduróz JC2, Tufik S2, Andersen ML2. Sleep Apnoea and Inflammation - Getting a Good Night's Sleep with Omega-3 Supplementation. Front Neurol. 2013 Dec 3;4:193.

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