Obstructive Sleep Apnea & Varicose Veins: Are They Related?
If you suffer from both obstructive sleep apnea (OSA) and varicose veins, you may be wondering if there is a connection between these two conditions. While they may seem unrelated at first glance, recent research has suggested that there could indeed be a link.
In this blog post, we'll explore the potential relationship between OSA and varicose veins and what it could mean for those affected by these conditions. We'll also provide some practical tips on how to manage both conditions simultaneously. We'll also discuss the potential causes of this link, such as shared risk factors or the impact of OSA on blood circulation.
What is obstructive sleep apnea?
According to the Mayo Clinic, obstructive sleep apnea is a sleep disorder characterized by repeated episodes of partial or complete obstruction of the upper airway during sleep. This obstruction leads to temporary breathing cessation, known as apneas or hypopneas, which can occur multiple times per hour throughout the night. The most common symptoms of OSA include loud snoring, gasping or choking sounds during sleep, and excessive daytime sleepiness.
Obstructive sleep apnea is a common disorder. According to the National Library of Medicine, OSA impacts nine to 15 percent of middle-aged adults worldwide. In the United States alone, OSA impacts 24 percent of men and 9 percent of women. It’s estimated that 82 percent of men and 93 percent of women in the United States are undiagnosed with the condition.
Health implications of obstructive sleep apnea
Uncontrolled sleep apnea has consequences beyond lost sleep for the person suffering the condition and the annoyance of their partner. Studies reported by Johns Hopkins Medicine have shown a link between sleep apnea and type 2 diabetes, stroke, heart attack, and even early death, citing obesity as the primary contributing factor.
What are varicose veins?
Have you ever felt a heavy, achy sensation in your legs after a long day? Or have you noticed visible bulging veins on your legs or feet? These could be signs of varicose veins, a condition where the valves within the veins become weakened or damaged, allowing blood to flow backward (known as reflux). Varicose veins are the result of blood pooling, causing the veins to swell and become twisted and visible just beneath the skin's surface.
Health implications of chronic venous insufficiency
Chronic venous insufficiency (vein disease) can have wide-ranging and potentially serious consequences for an individual's health and well-being if left untreated.
Venous disease symptoms
Vein disease can cause leg swelling, feelings of heaviness, cramping, itching, skin changes, and venous ulcers, which are difficult to heal sores that can become infected. Mobility can be severely impacted, leading to decreased quality of life.
Deep vein thrombosis
Another significant concern is the increased risk of developing deep vein thrombosis (DVT), where a blood clot forms in a deep vein, usually in the leg. If the clot breaks free and travels to the lungs, DVT can lead to a potentially life-threatening condition called pulmonary embolism (PE).
Varicose veins
While often (erroneously!) considered a cosmetic issue, varicose veins can be a medical issue that causes significant pain, heaviness, itching, and fatigue in one or both legs. They can also lead to complications like bleeding if the vein walls become thin and rupture. Genetics, pregnancy, obesity, standing or sitting for long periods, and aging are risk factors for developing varicose veins.
Restless leg syndrome
Vein disease has also been linked to an increased risk of restless leg syndrome (RLS), which can severely disrupt sleep. The impaired return of blood from the legs caused by vein issues may contribute to unpleasant sensations and the urge to move the legs, which is characteristic of RLS. Studies have found a higher prevalence of RLS among those with varicose veins and other venous disorders compared to the general population.
Overall, untreated vein disease can have significant impacts on cardiovascular health, mobility, and quality of life. Seeking proper evaluation and treatment is crucial to avoid potentially serious complications.
Center for Vein Restoration (CVR) is America's largest physician-led vein center. It offers comprehensive treatment for chronic venous insufficiency. With 110+ centers in 22 states and 70+ active physicians, CVR boasts a 98 percent patient satisfaction rating.
The potential link between obstructive sleep apnea and varicose veins
While the connection between OSA and varicose veins may not be immediately apparent, several studies have suggested that there could be a relationship between these two conditions.
A study reported by the National Library of Medicine (NIH) called “Obstructive Sleep Apnea and Vascular Disease” found that people with OSA are more likely also to have chronic venous insufficiency that contributes to the formation of varicose veins. The proposed reason for this connection is that the changes OSA causes in the body may impair normal blood vessel function.
The repeated drops in oxygen levels and activation of the body's stress response during apnea episodes can lead to fluid buildup in the legs. This fluid accumulation and disrupted blood flow may then promote the development of varicose veins over time.
In another study titled “Prevalence and Predictors of Elevated Central Venous Pressure And Obstructive Sleep Apnea In Patients With Lower Extremity Chronic Venous Disease,” researchers found that patients with chronic venous disease (CVD) also have elevated central venous pressure (CVP) and obstructive sleep apnea (OSA).
Specifically, the researchers found that 22.7 percent of the 264 CVD patients had elevated CVP, and 26.9 percent had OSA. The main predictors of elevated CVP were:
- Age over 64.6 years
- Having diabetes
- Having severe chronic venous insufficiency symptoms (swelling, heaviness, varicose veins) in the right lower leg
Other predictors included a history of pulmonary embolism and kidney problems. The researchers noted that the prevalence of elevated CVP and obstructive sleep apnea in this chronic venous insufficiency patient group was higher than in the general population.
Obstructive Sleep Apnea & Varicose Veins: The Bottom Line
While obstructive sleep apnea and varicose veins may seem unrelated at first glance, growing evidence suggests that these two conditions could be linked through their impact on the cardiovascular and venous systems. By understanding this potential connection and working closely with healthcare providers, individuals affected by these conditions can take steps to manage their symptoms and reduce the risk of further complications.
For those with OSA, treating the condition through methods such as continuous positive airway pressure (CPAP) therapy or oral appliances can help alleviate the strain on the cardiovascular system and potentially reduce the risk of developing varicose veins or other venous complications.
Treatment for varicose veins
For individuals with varicose veins, treating the underlying venous disease is the most important thing one can do to improve the symptoms of OSA and reduce the strain on the cardiovascular system.
Many minimally invasive outpatient treatment options are available to address varicose veins effectively. These treatments offer effective and minimally invasive solutions, allowing patients to resume their normal activities quickly with minimal downtime and discomfort.
Below is a small sample of the office-based treatment options available at Center for Vein Restoration (CVR):
Endovenous laser ablation (EVLA)
One of the most widely used outpatient treatments, this minimally invasive procedure involves inserting a thin laser fiber into the affected vein under ultrasound guidance. The laser energy then heats and seals the vein, causing it to collapse and reroute blood flow to healthier veins.
A popular, safe, and effective option involves injecting a solution called a sclerosant into the varicose veins. The sclerosant irritates the vein walls, causing them to scar and eventually collapse. This procedure is often recommended for smaller varicose veins or spider veins.
Another minimally invasive treatment that uses radiofrequency energy to heat and seal the affected veins. This technique is similar to EVLA but uses radiofrequency energy instead of laser energy.
Varithena (polidocanol injectable foam)
This minimally invasive outpatient treatment option is FDA-approved for treating varicose veins. Under ultrasound guidance, a sclerosing foam is injected into the affected veins. The foam irritates the vein's inner lining, causing it to collapse and ultimately get absorbed by the body. Blood flow is then redirected to healthier veins.
Only your board-certified Center for Vein Restoration specialist can determine the most appropriate course of treatment based on your individual circumstances. CVR accepts many insurances, including Aetna, Amerigroup, Anthem, Blue Cross/Blue Shield, Cigna, MultiPlan, Medicaid, Medicare, and more.
Call 240-965-3915 to speak to a Patient Services Representative or schedule your consultation online at a CVR near you today.