Supreme Court Justice Antonin Scalia and Sleep Apnea

In has recently been reported that Supreme Court Justice Antonin Scalia suffered from sleep apnea. With much coverage of his life and death, it is important to recognize the ubiquity of this potentially deadly sleep disorder.

Over 5% of the adult population has some degree of obstructive sleep apnea, which is characterized by repetitive pauses in breathing. Some estimates push the prevalence of sleep apnea to over 10%. Obstructive sleep apnea (OSA) is usually caused by anatomic structures in the back of the throat. Mild OSA is defined by having over 5 events per hour. People with severe sleep apnea have over 30 events per hour.

In this week’s HuffPo article, Dr. Dan Kripke from Scripps Clinic Sleep Center discusses the death of Justice Scalia and opines on the significance of sleep apnea and his demise:

“Our research shows that 29% of men in this age group suffered from sleep apnea, as defined by at least five apneas per hour of sleep. Sleep apnea means cessations of breathing during sleep. The rate and likely severity of sleep apnea is elevated among men with obesity, and pictures of Justice Scalia show a massive double chin, one of the best predictors of sleep apnea. He also had hypertension, which is associated with sleep apnea. The altitude of the Cibola Creek Ranch is approximately 4,400 feet. Sleep apnea usually grows worse at higher altitudes because blood oxygen drops. It appears likely that Justice Scalia suffered from sleep apnea, but we do not know if he had been treated. No mention was made that he was seen to be using a treatment for sleep apnea when he died.”

Reference: http://www.huffingtonpost.com/daniel-f-kripke-md/questions-about-the-death_b_9246854.html

 

 

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3 Replies to “Supreme Court Justice Antonin Scalia and Sleep Apnea”

  1. john whitsitt, DDS,FACP

    With the possibility that justice Was not treating his sleep apnea either with a CPAP or Sleep appliance ( mandibular advancement splint or MAS) Would seem understandable that he should succumb to the negative effects of sleep apnea. The comorbidities that exist for a patient with untreated sleep apnea often include: heart failure, cardiac arrhythmias especially AFIB, strokes, diabetes II ,GERD,Respiratory and cardiac hyperpertension, obesity,cognitive dysfunction, snoring, and dyslipidemia. I am a dentist who has severe sleep apnea and Provides patients who are CPAP noncompliant with oral appliances that reduce the patient’s level of sleep apnea.Regardless of the type of treatment provided for sleep apnea patient. It is tragic that he simply may not have been using either approaches and left himself vulnerable to the serious effects of his obstructive sleep apnea.

  2. George Balfour

    Dr I am not familiar with mandibular advancement splints or their effectiveness. If you have some selected literature I would be appreciative if you would share some of the better articles. You might want to consider including Cpap prescription in your scope of practice. Untreated sleep apnea so common and so undertreated that even dentists would be making a contribution to public health by prescribing cpap machines as well as mandibular applicances

    George Balfour MD

  3. Kendell Lang

    Unfortunately the legislation and regulation around diagnosing sleep has not caught up with the science and general understanding of comorbidities around OSA. Dentists, by law, are not allowed to diagnose or treat OSA. Only an MD who is board certified in sleep can diagnose OSA and then prescribe treatment. Dentists can certainly partner with MD’s in the holistic treatment of patients who may not be CPAP compliant or for patients who prefer an oral appliance to CPAP. Non-compliant CPAP patients should certainly be recommended for evaluation of an oral appliance because, as this article points out, the risks of OSA being fatal due to not using CPAP should be motivation enough to explore an oral device as an alternative. You can learn more about where dentists can learn more about how to build their own Sleep Practice

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