The liver
The liver is a large organ that sits on the right side of your abdomen, underneath the ribcage. The liver performs over 500 functions, but the main ones are to:
- Take in and store glucose after each meal
- Release glucose when you haven’t eaten for several hours
- Break down fats to produce energy after each meal
- Break down excess amino acids after each meal (amino acids are the building blocks of protein)
- Convert excess glucose and amino acids into fats
- Process alcohol, toxins and drugs.
Non-alcoholic fatty liver disease (NAFLD)
Usually liver cells are relatively fat-free. When fat starts to build up within them, you have what is known as ‘non-alcoholic fatty liver disease’ (NAFLD). Most people with fatty liver disease remain at stage 1 and do not show any symptoms. In some people the disease progresses and can eventually lead to liver cirrhosis.
Obstructive Sleep Apnoea and NAFLD
Fatty liver disease is normally linked to someone whose diet is high in fat or sugar and who is overweight or obese. However, Obstructive Sleep Apnoea is a risk factor for NAFLD even if you are not overweight. In fact, if you have Obstructive Sleep Apnoea you are two and a half times more likely to experience NAFLD.
There are four main possible reasons for this:
- Repeated apnoeas cause fluctuations in oxygen during sleep – This could stress the liver cells and increase the amount of fat they accumulate.
- Sleep apnoea activates the ‘fight or flight’ response – This causes fat cells to release fat into the blood, which can be taken up by the liver.
- Sleep apnoea worsens type 2 diabetes – A risk factor for non-alcoholic fatty liver disease.
- Sleep apnoea causes high blood pressure – Which can lead to non-alcoholic fatty liver disease.
Can treating sleep apnoea help?
Recent research suggests that treating sleep apnoea with CPAP helps your liver to function, especially if you have used your machine for at least three months. However, bigger and better trials involving many patients are required to confirm this.
