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Can Sleep Apnea Cause Heart Problems

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How Sleep Apnea Contributes To Lack Of Sleep

Sleep apnea also can be a symptom of heart disease

Sleep apnea keeps you awake and ruins your sleep cycle. But it is more than just bothersome to you and your partner it can have life-threatening consequences. Lack of sleep due to sleep apnea means the heart and cardiovascular system dont get vital recovery time.

Ongoing research from AHA links sleep-disordered breathing to cardiovascular disease. If you have sleep apnea, you are two to four times more likely to develop an abnormal heart rhythm than someone without this condition. In fact, sleep apnea increases the risk of heart failure by 140 percent and the risk of coronary heart disease by 30 percent. If you suspect you have sleep apnea, talk to your doctor.

What Are The Symptoms Of Central Sleep Apnea

The most common symptom of central sleep apnea is short periods during sleep when breathing stops. Some people exhibit very shallow breathing instead of actually stopping breathing. You may wake up feeling short of breath. The lack of oxygen can cause you to wake up frequently throughout the night, and can lead to insomnia.

Other symptoms associated with central sleep apnea occur during the day as a result of an interrupted nights sleep. You may feel very sleepy during the day, have trouble concentrating or focusing on tasks, or have a headache when you wake up.

Central sleep apnea caused by Parkinsons disease or other neurological conditions can be characterized by additional symptoms, including:

  • difficulty swallowing

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Getting Tested For Sleep Apnoea

If a GP thinks you might have sleep apnoea, they may refer you to a specialist sleep clinic for tests.

At the clinic, you may be given devices that check things like your breathing and heartbeat while you sleep.

Youll be asked to wear these overnight so doctors can check for signs of sleep apnoea.

You can usually do this at home, but sometimes you may need to stay in the clinic overnight.

The test can show if you have sleep apnoea and how severe it is. This is based on how often your breathing stops while you sleep .

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Sleep And High Blood Pressure

Several studies have shown that people with obstructive sleep apnea are at a much greater risk of having high blood pressure. OSA causes your oxygen level to drop. Your heart beats faster due to the lack of oxygen. This causes your blood pressure to rise. Over time, this can lead to an ongoing increase in blood pressure. It is important to treat high blood pressure since it is a proven cause of other forms of cardiovascular disease. This includes heart attack, heart failure and stroke.

But treating high blood pressure may not be enough. When high blood pressure does not respond well to treatment, it is often due to the presence of untreated sleep apnea. Once the OSA is treated, then the high blood pressure tends to improve as well. It is vital for your doctor to determine if a sleep disorder such as OSA is a factor in your high blood pressure.

Why Choose Ohio State For Sleep Apnea Treatment

Can Sleep Apnea Cause Heart Problems?

Ohio State’s Wexner Medical Center has pioneered an outpatient treatment approach for sleep apnea. This approach involves sleep specialists and cardiologists seeing patients together in an integrated program that is improving patients’ quality of life. It also promotes research to better understand links between sleep apnea and heart disease.

The sleep medicine and cardiology researchers at Ohio State’s Wexner Medical Center were the first to evaluate the impact of common sleep disorders on heart failure patients.

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A Heart Failure With Reduced Left Ventricular Ejection Fraction

Sleep studies of consecutive patients with stable HFrEF have been reported from various countries with either polysomnography or polygraphy .1-3

The most detailed systematic prospective study in HFrEF involved 100 ambulatory male patients with stable, treated HF.6 Each patient spent two nights in the sleep laboratory, with the first night for habituation. Polysomonography was performed during the second night. 49% of the patients had an AHI of 15 per hour of sleep. In the general population, only 9% of men have an AHI15/h. For reference, an AHI of 5 to < 15, 15 to < 30 and 30 or more are considered mild, moderate and severe sleep apnea, respectively.

In our study, 10% of the patients were taking -blockers. However, in spite of wide spread use of -blockers, the prevalence of sleep apnea in CHF has remained quite high. Combining results of studies from consecutive CHF patients from around the world shows that 52% have an AHI 15/hour .3 In most of these studies, 80% to 90% of the patients were on a -blocker. In these studies, 31% had CSA and 21% had OSA however, this distribution varies considerably among various reports, in part due to difficulties involved in differentiating central and obstructive hypopneas from each other.

The Dangers Of Uncontrolled Sleep Apnea

Youve probably heard that regular exercise and a heart-healthy diet arethe most important things you can do for your cardiovascular health. As itturns out, though, the quality of sleep you receive is also critical toyour hearts wellbeing.

In particular, undiagnosed sleep apnea is directly tied to an increased risk in cardiovascular and metabolic health. The scariest part? You might not even know you have this very common problem.

Sleep apnea happens when upper airway muscles relax during sleep and pinch off the airway, which prevents you from getting enough air. Your breathing may pause for 10 seconds or more at a time, until your reflexes kick in and you start breathing again, explains Jonathan Jun, M.D. , a pulmonary and sleep medicine specialist at the Johns Hopkins Sleep Disorders Center.

Sleep apnea occurs in about 3 percent of normal weight individuals but affects over 20 percent of obese people, Jun says. In general, sleep apnea affects men more than women. However, sleep apnea rates increase sharply in women after menopause. Sleep apnea is often linked to heart disease and metabolic issues like diabetes.

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Does Sleep Apnea Cause High Blood Pressure

Sleep Apnea plays a very important role in causing high blood pressure, but it is not the only cause1. High blood pressure has been linked to many things, including:

  • Diet
  • Caffeine Intake
  • Sleep Conditions

Improving any one of these risk factors can lower your blood pressure. Studies have also found that in instances where a persons blood pressure is being treated but is not fully regulated, Sleep Apnea treatment can help.

Typically, Sleep Apnea treatment involves using Continuous Positive Airway Pressure therapy through either a CPAP machine, APAP machine, or BiPAP machine to blow pressurized air into the airway, causing the relaxed muscles of the airway and throat to open up.

This, in turn, allows air to reach the lungs. Provided you use your therapy equipment regularly, it can help raise blood oxygen during sleep. As blood oxygen saturation goes up, blood pressure goes down.

Sleep Apnea can also indirectly influence blood pressure. If youre not sleeping, you may go through your day tired. In these situations, you may consume more caffeine to help stay awake. Increased caffeine consumption can lead to higher blood pressure readings. If Sleep Apnea is adequately treated, you may need less caffeine to stay awake.

Sleep And Blood Pressure

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During normal, healthy sleep, blood pressure drops by around 10-20%. This is known as nocturnal dipping, and research highlights its role in cardiovascular health.

Poor sleep, whether from a lack of sleep or sleep disruptions, is associated with non-dipping, meaning that a persons blood pressure doesnt go down at night. Studies have found that elevated nighttime blood pressure is tied to overall hypertension .

In fact, nocturnal blood pressure has been found to be even more predictive of heart problems than high blood pressure during the day. Non-dipping has been tied to an increased risk of stroke and heart attack. Its also been linked to kidney problems and reduced blood flow to the brain.

Raised daytime blood pressure has been identified as a consequence of sleep deprivation in multiple studies, but it doesnt affect all people equally. The link between lack of sleep and high blood pressure is highest in middle-aged adults. People who work long hours in high-stress jobs and people with other risk factors for hypertension are more likely to have raised blood pressure after chronic poor sleep.

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Sleep And Type 2 Diabetes

Type 2 diabetes is a chronic condition in which the level of blood sugar, also known as blood glucose, is too high due to the bodys inability to process sugar properly. Excess blood glucose damages blood vessels, negatively affecting cardiovascular health. People with diabetes are twice as likely to die from heart disease or stroke than people without this condition.

Many factors affect blood sugar, but studies have found that a lack of sleep worsens glucose metabolism. Poor sleep is associated with prediabetes, a a type of glucose intolerance that does not meet the parameters for diabetes. People already diagnosed with diabetes who have insufficient or restless sleep may have a harder time controlling their blood sugar. Impaired sleep may also worsen the hardening of arteries in people with type 2 diabetes.

Sleep For People With Heart Disease

Because sleep deprivation can harm the heart, its important for people with cardiovascular problems to make getting good sleep a priority. Some evidence even indicates that improving sleep may reduce the likelihood of heart attacks or other cardiovascular problems in people who are otherwise at high risk.

Unfortunately, some heart problems can interfere with sleep. For example, diabetes can cause frequent nighttime urination, and other cardiovascular disorders may create chest discomfort when trying to get to sleep. Worry and anxiety about heart health can also make it hard to wind down and fall asleep normally.

Because numerous factors can influence both sleep and cardiovascular health, its most helpful to talk with your doctor about heart-healthy sleep. A doctor can help develop a specific plan to improve your sleep while also addressing other lifestyle factors, such as diet and exercise, that are important for your heart and overall wellness.

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E What Can I Do For Sleep Apnea

Weve talked about the connection between sleep apnea and daytime panic attacks, so lets make sure youre doing everything you can do to tackle your sleep apnea.

Today, its a very treatable condition. Sadly, most people with sleep apnea go undiagnosed and dont get properly treated.

Heres what you can do:

Get properly diagnosed A sleep specialist can make sure youre taking the right steps. Theyll check for other things that may be hurting your sleep or contributing to your sleep apnea. They can also help you try out different treatments and work with insurers to get them covered.

Lifestyle changes For mild obstructive sleep apnea, changes in daily activities might be enough to help, including getting regular sleep and avoiding substances like alcohol that can relax your throat too much.

Change your sleep position Switching to your side may help keep your throat open if you have obstructive sleep apnea.

Lose weight Weight loss can help improve symptoms for some patients.

Get properly treatedCPAP is currently the gold standard for treatment, although some people find the mask and blowing air uncomfortable. Dont let this stop you, theyre now plenty of alternatives you can try besides oral appliances and surgery.

Isnt Sleep Apnea Just A Fancy Name For Snoring

How Chronic Snoring Can Cause Heart Disease

Not at all. Snoring is that annoying sound that occurs when air passes relaxed tissues in your throat as you sleep. Sleep apnea is a disorder in which a persons breathing repeatedly starts and stops during sleep. Not everyone who snores has sleep apnea, but many who have sleep apnea do snore regularly and loudly. One in five adults suffers from at least mild sleep apnea it afflicts more men than women. The most common type is obstructive sleep apnea , in which weight on the upper chest and neck contributes to blocking the flow of air. A less-common type, central sleep apnea , occurs when the brain fails to send regular signals to the diaphragm to contract and expand. CSA has been associated with brain stem stroke.

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Treating Sleep Apnea To Reduce The Risk Of Heart Disease

Talking to a doctor about sleep apnea is an important step that anyone can take to protect their heart health. If a person is diagnosed with sleep apnea, treatments are often effective. Treatment for sleep apnea depends on the type of sleep apnea detected and may include:

  • Lifestyle changes: Doctors may begin by informing patients about lifestyle changes that may reduce the severity of this condition. Weight loss, exercise, limiting alcohol, quitting smoking, and even changing your sleeping position may be helpful.
  • Positive airway pressure devices: PAP devices pump air through the airway, preventing the upper airway from collapsing during sleep.
  • Mouthpieces and oral appliances: Oral appliances reduce disordered breathing by changing the position of the jaw, tongue, or other part of the body thats constricting the airway.
  • Mouth and throat exercises: Depending on the cause of a persons sleep apnea, special exercises of the mouth and throat may help tone these muscles, making them less likely to interfere with breathing during sleep.
  • Surgery: Surgery for sleep apnea may involve changing parts of the body that cause airway constriction or implanting devices that causes tightening of the muscles around the airway.
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Basic Mechanisms Of Cardiovascular Disease In Osas

The mechanisms underlying cardiovascular disease in patients with OSAS are still poorly understood. The pathogenesis is likely to be a multifactorial process involving a diverse range of mechanisms including sympathetic nervous system overactivity, selective activation of inflammatory pathways, endothelial dysfunction and metabolic dysregulation, with the latter particularly involving insulin resistance and disordered lipid metabolism.

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What Is The Relationship Between Sleep And Heart Disease

The relationship between sleep and heart disease is complex but undeniable. Astudy that looked at sleep duration and heart attack found that sleeping less than six hours per night increases your risk of a heart attack by 20 percent.

During sleep, you cycle through two phases: non-rapid eye movement and rapid eye movement . Though it may seem like nothing is happening when you sleep, these phases are both essential to your waking health. Quality sleep helps you cope with stress, problem solve, and recover from illness.

Non-REM sleep stage helps the heart slow down and recover. On the other hand, REM sleep increases breathing rate and brain activity, helping encode memories and aid in learning. Not enough sleep can throw these two stages out of whack increasing heart attack risk.

Sleep Apnea And Cardiovascular Disease: Role Of The Metabolic Syndrome

Sleep apnea linked to heart disease and stroke

The relationships between sleep apnea and cardiovascular disease are rather complex. Several systematic studies are necessary to explicate fully the nature of those relationships. These complexities are further compounded by findings suggesting that conditions comprising the metabolic syndrome might mediate effects of sleep apnea on cardiovascular disease .

Prevalence of metabolic syndrome components and cardiovascular disease among patients with a diagnosis of sleep apnea risks of cardiovascular disease for patients with sleep apnea are also indicated.

A direct link between the metabolic syndrome and sleep apnea has not been established, as previous research has considered linkage analysis only for individual components of the metabolic syndrome. Recent preliminary evidence from the Mayo Clinic suggests that the metabolic syndrome might be more prevalent among patients with obstructive sleep apnea than among individuals without OSA. Clinical data show that 60% of patients with sleep apnea had the metabolic syndrome, compared with 40% of patients without sleep apnea. In the following sections, we consider the role of each component of the metabolic syndrome namely obesity, hypertension, diabetes, and dyslipidemia but first, issues pertaining to definition and prevalence of the metabolic syndrome are presented.

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Other Positive Airway Pressure Breathing Devices

In addition to CPAP, there are other devices that a sleep specialist may recommend for sleep apnea treatment.

Expiratory positive airway pressure single-use devices fit over the nostrils to help keep the airway open and are smaller, less intrusive than CPAP machines. These may benefit people with mild-to-moderate obstructive sleep apnea.

Bilevel positive airway pressure devices can be used for those who are unable to adapt to using CPAP, or for central sleep apnea sufferers who need assistance for a weak breathing pattern. This device automatically adjusts the pressure while youre sleeping, providing more pressure when you inhale, less when you exhale. Some BiPAP devices also automatically deliver a breath if the mask detects that you havent taken one for a certain number of seconds.

Adaptive servo-ventilation devices can be used for treating central sleep apnea as well as obstructive sleep apnea. The ASV device stores information about your normal breathing pattern and automatically uses airflow pressure to prevent pauses in your breathing while youre asleep.

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Sleep Apnea Tied To Heart Problems After Surgery

By Lisa Rapaport

4 Min Read

– People having surgery may be more likely to experience cardiovascular problems afterward when they have a common nighttime breathing disorder known as sleep apnea, a study suggests.

Compared to patients without apnea, people with severe apnea were more than twice as likely to die of heart complications or experience serious cardiac events like heart attacks and strokes within 30 days of surgery, researchers report in JAMA.

Previous research suggests that sleep irregularities can increase the risks for a variety of cardiovascular disorders, such as clogged or hardened arteries, high blood pressure, irregular heartbeat, and stroke, as well as metabolic problems like high cholesterol, obesity and diabetes that all contribute to cardiovascular disease.

For the current study, researchers did sleep studies for 1,218 patients before they had surgery for conditions unrelated to heart disease. None of the patients had been previously diagnosed with apnea – which occurs when breathing repeatedly stops and starts during sleep – but two-thirds of them were found to have the condition based on their sleep study results.

In patients with severe obstructive sleep apnea, there are repeated episodes of complete or partial airway obstruction during sleep, said lead study author Dr. Matthew Chan of the Chinese University of Hong Kong.

Patients with mild and moderate apnea were typically overweight, and people with severe apnea tended to be obese.

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