An autopsy report has revealed that actress and writer Carrie Fisher died of sleep apnea, along with other factors, The Los Angeles Times and other outlets reported. The medical examiner also listed atherosclerotic heart disease and drug use as “other conditions.” Cocaine, methadone, MDMA (ecstasy), alcohol and opiates were found in Fisher’s system.
While the drugs have made for splashier headlines, the dangers of sleep apnea — especially as we age — are often misunderstood and discounted.
A 2013 Mayo Clinic study found a link between obstructive sleep apnea and cardiac death. “The presence and severity of sleep apnea are associated with a significantly increased risk of sudden cardiac death,” said study leader Dr. Apoor Gami in a statement. Gami is a cardiac electrophysiologist at Midwest Heart Specialists-Advocate Medical Group in Elmhurst, Ill.
Sleep apnea is literally when a person stops breathing during sleep.
— Dr. Paul G. Mathew, Harvard Health Blog
The study, published in the Journal of the American College of Cardiology, built on the scientists’ earlier research that showed people with obstructive sleep apnea more commonly died suddenly of cardiac death between the hours of 10 p.m. to 6 a.m. — which is the least likely time for such deaths among the general population, the American College of Cardiology said.
What Happens in Sleep Apnea?
“Sleep apnea is literally when a person stops breathing during sleep,” said Dr. Paul G. Mathew, in the online Harvard Health Blog. “As a result, the brain undergoes repeated moments of suffocating.”
That happens when the throat muscles collapse, the tongue falls back and the airway is blocked, leading to snoring, according to the UCLA Sleep Disorders Center. The condition affects an estimated one in four people over 60, it said.
The sleeping person will often awake briefly with a loud snort, which, while the subject of jokes, “is often the person gasping for air as the brain is not getting enough oxygen,” Mathew wrote. Untreated sleep apnea “leads to an increased risk of stroke, heart attack and dementia (brain damage).”
Fisher Had Apnea on the Plane
Fisher, 60, died Dec. 27 in Los Angeles. Four days earlier, the beloved Princess Leia of the Star Wars series had collapsed of heart failure on a plane from London to LA. According to The Los Angeles Times, it is unclear from the autopsy report whether Fisher took any drugs on the day of the flight.
While Fisher slept on the plane, she experienced several episodes of apnea, her assistant reported to authorities. But that was common for her, the assistant said. When they were almost to Los Angeles, Fisher could not be awakened, The Los Angeles Times said.
Many people with sleep apnea are overweight. But those conditions don’t necessarily go hand in hand, said Dr. Raj Dasgupta, a sleep specialist and an assistant professor of clinical medicine at the Keck School of Medicine at the University of Southern California. “We used to stereotype the patients with sleep apnea as being the overweight, obese type individual. But the people with sleep apnea probably look like [they’re at a healthy weight],” he said.
The explanation? The obstruction that causes sleep apnea is in the upper airway, not the gut, Dasgupta said. “That’s why there’s a whole new mentality when we approach someone with obstructive sleep apnea. We’re being more diligent about evaluating it in any of our patients who have some symptom.” he added.
Older adults are significantly more likely to have sleep apnea, according to the Mayo Clinic.
Symptoms of Sleep Apnea
According to the National Heart, Lung, and Blood Institute,, the symptoms of obstructive sleep apnea include:
- Loud and chronic snoring
- Gasping or choking after a pause in the snoring
- Waking up often during the night to urinate
- Daytime sleepiness
- Dry mouth or sore throat when awakening
- Trouble focusing, forgetfulness, irritability, depression
- Morning headaches
You may not realize that you snore or gasp when you sleep. Brief awakenings may also go unnoticed. Many people become aware of a problem because their bed partner brings it to their attention, experts said.
Home Sleep Test Available
“If you’re a snoring person, you better make sure you rule out sleep apnea,” Dasgupta advised.
That’s now easier than it used to be because of the existence of home sleep studies. Instead of sending patients to a sleep center, a doctor who suspects obstructive sleep apnea prescribes the home test, which lasts for one to three nights.
There’s no question that sleep apnea can be deadly, Dasgupta said. “It’s going to contribute to higher blood pressure, poorly controlled blood sugar, stroke, atrial fibrillation, just to name a few,” he noted.
Dasgupta also pointed out that daytime sleepiness can cause tragic and even fatal vehicle accidents.
Fisher was the daughter of actress and singer Debbie Reynolds and actor and singer Eddie Fisher. Reynolds died of a stroke the day after her daughter.
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