Title Moderate Levels Of Alcohol Consumption May Or May Not Be A Risk Factor For Obstructive Sleep Apnea Syndrome
Clinical Question Are adults who consume moderate levels of alcohol at an increased risk of developing obstructive sleep apnea syndrome compared to adults who do not consume alcohol?
Clinical Bottom Line Excessive alcohol consumption is a risk factor for obstructive sleep apnea syndrome (OSAS). However, the multitude of risk factors typically present in patients makes it difficult to clearly isolate a cause and effect relationship between alcohol intake and OSAS and needs further investigation. An assessment of individuals without these numerous risk factors would be beneficial in gathering more conclusive data. (See Comments on the CAT below)
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
8947088Teschler/199614 adult malesRandomized Control Trial
Key resultsThe study was conducted on 14 adult males with untreated OSAS but without heart or lung disease. The participants underwent four consecutive nights of polysomnography with different conditions including control, alcohol, CPAP, alcohol and CPAP. The data suggests that a moderate amount of alcohol intake has no statistically significance on individual apnea/ hypopnea indices (AHI), sleep pattern or arterial oxygen saturation during sleep in patients with OSAS. Also, the pressure required to maintain continous positive airflow pressure remained the same after moderate alcohol intake.
11153591Scanlan/200021 adult malesRandomized Control Trial
Key resultsThe study was conducted on 21 adult males with habitual snoring but without heart or lung disease. The participants underwent two sleep studies one week apart under two conditions of with or without alcohol. The study found no significant changes in various sleep stages and in arterial oxygen saturation; however, individual AHI and the mean sleep cardiac frequency data (fC) were significantly greater following alchol intake compared with the contol.
Evidence Search ("obstructive sleep apnoea"[All Fields] OR "sleep apnea, obstructive"[MeSH Terms] OR ("sleep"[All Fields] AND "apnea"[All Fields] AND "obstructive"[All Fields]) OR "obstructive sleep apnea"[All Fields] OR ("obstructive"[All Fields] AND "sleep"[All Fields] AND "apnea"[All Fields])) AND ("alcohol drinking"[MeSH Terms] OR ("alcohol"[All Fields] AND "drinking"[All Fields]) OR "alcohol drinking"[All Fields] OR ("alcohol"[All Fields] AND "ingestion"[All Fields]) OR "alcohol ingestion"[All Fields]) AND Randomized Controlled Trial[ptyp]
Comments on
The Evidence
Teschler and Scanlan focused on determining the affects of moderate alcohol consumption on OSA in relativing healthy male participants. In Teschner, the data showed insignificant changes in sleep-disordered breathing while Scanlan's data showed elvated AHI and fC on the alcohol night. A possible explanation for the variation is the differences in the terminology and methods. Teschber and Scanlan used different explanations for determining AHI. Also, Scanlan checked the particpant's blood alcohol content(BAC) before bed whereas Teschler did not. The level of BAC coud play a role in the the participants responses in a trial.
Applicability Ultimately, when a patient presents with OSAS, it remains prudent for the clinician to be aware and to appropriately treat or refer the patient for obstructive sleep apnea syndrome evaluation as needed. Moderate alcohol intake should be considered as possibly having a negative effect on OSAS.
Specialty (Dental Hygiene)
Keywords obstructive sleep apnea AND alcohol ingestion
ID# 2395
Date of submission 03/21/2013
E-mail draustinwebb@gmail.com
Author Austin Webb
Co-author(s) Stephanie Lomeli
Co-author(s) e-mail lomeli@livemail.uthscsa.edu
Faculty mentor
Faculty mentor e-mail
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
by Kelsey Rockey and Ann Sue von Gonten (San Antonio, TX) on 05/15/2013
The PubMed database was searched for the above terms on 5/13/13, and the articles discussed in this CAT were confirmed as the highest level of evidence published on this topic. Additional support for the conclusion is provided in an article published in 2012 (PMID 22841037 ) and in a 2007 publication (PMID 17561593 ). In the Koyama study, 35.03% of 745 Brazilian male railway workers were diagnosed with OSA using polysomnography. Among those with OSA, 54.7% reported alcohol use. The study by Peppard et al. utilized a questionnaire to determine a positive correlation between alcohol use and increased sleep disordered breathing (SDB- as measured by AHI). In a sample of 775 men, they found that when compared to men who consumed less alcohol, those who consumed more alcohol had a 25% greater propensity to mild or worsened SDB (OR = 1.25, 95% CI = 1.07 - 1.46, p = 0.006).