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Sleep apnea: A much bigger worry than just snoring
Obstructive sleep apnea (OSA) occurs in between 40 and 80 percent of people with cardiovascular disease.
This month, a scientific statement from the American Heart Association urged increased awareness of OSA in people with cardiovascular disease, or with risk factors such as high blood pressure.
“Obstructive sleep apnea can negatively impact patients’ health and increase the risk of cardiovascular events and death. This statement is to encourage increased awareness, screening and treatment as appropriate for sleep apnea,” said Chair of the scientific statement writing group Yerem Yeghiazarians, M.D., FAHA, professor of medicine and the Leone-Perkins Family Endowed Chair in Cardiology at the University of California, San Francisco.
Here’s what you need to know about OSA, its signs and symptoms, and how it puts your heart at risk.
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Obstructive sleep apnea: not just a sleep problem
Make no mistake — sleep apnea and snoring are not the same things.
Snoring is the annoying sound that happens when air passes over the relaxed tissues in your throat as you sleep.
Sleep apnea, on the other hand, is a disorder in which a person’s breathing repeatedly stops and starts during sleep.
Each time weight overpowers the muscles that keep the upper airway open, a person with obstructive sleep apnea stops breathing. This can happen up to 30 times an hour or more, causing the person with OSA to wake up suddenly, gasping for air.
OSA is associated with several cardiovascular complications, as detailed in the scientific statement from the American Heart Association. Here are 7 ways sleep apnea harms your heart:
- High blood pressure – OSA is present in 30-50 percent of people with high blood pressure, and up to 80 percent of those who have resistant, or hard-to-treat high blood pressure;
- Heart rhythm disorders such as atrial fibrillation and sudden cardiac death;
- Stroke;
- Worsening heart failure;
- Worsening coronary artery disease and risk of heart attack;
- Pulmonary hypertension (PH) – as many as 80 percent of people with PH have OSA; and
- Metabolic syndrome and Type 2 diabetes.
Who is at risk for OSA
People who are overweight are especially at risk for OSA. Fat deposits around the upper airway can cause the airway’s muscles to lose tone over time, which causes obstructed breathing.
People with thicker necks, narrow throats or enlarged tonsils or adenoids may also be at risk.
If you have a family history of OSA, or you are a heavy drinker or smoker, your risk is also higher.
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How do you know if you have OSA
Loud snoring, interrupted breathing and gasping for air may be observed by someone else. Other signs include:
- Waking up with a dry mouth
- Morning headaches
- Difficulty sleeping, or excessive daytime sleepiness
- Irritability or trouble paying attention during the day
You may need a sleep specialist to do testing in order to diagnose your condition. (Testing will also help determine how severe your condition is. This is important, as it will help determine treatment options).
For example, a test called polysomnography monitors your heart, lung and brain activity and your movements during sleep. This helps rule out other sleep disorders like restless leg syndrome or narcolepsy.
Treatment for OSA
A moderate to severe case of OSA will need to be treated by a doctor.
A continuous positive airway pressure (CPAP) machine is the most common method for treating OSA. It pushes a steady stream of air through a mask or mouthpiece that you wear while sleeping. This keeps your airway open.
Oral appliances, known as mandibular advancement devices, can also help. Some are designed to bring your jaw forward to open your airway. Others hold your tongue in place. These devices are usually custom-made by a dentist.
A third treatment method is upper airway stimulation. A small electrical device similar to a heart pacemaker is placed below the skin in the chest. An electrode delivers a small electrical charge to your tongue muscles, keeping your airway open. That may sound extreme, but remember, sleep apnea harms your heart.
If your case of OSA is mild but is keeping you from getting a proper night’s sleep, your doctor will recommend some lifestyle changes:
- Get regular physical activity
- Limit alcohol intake to one drink per day for women, two per day for men
- Avoid caffeine before bed
- Weight loss, if you are overweight or obese
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Sources:
Sleep apnea worsens heart disease, yet often untreated — Eureka Alert
What you need to know about how sleep apnea affects your heart — American Heart Association
Stress Hormone Predicts Heart Death — Web MD
Obstructive Sleep Apnea and Cardiovascular Disease: A Scientific Statement From the American Heart Association — Circulation
Sleep apnea treatment options — Web MD
By Joyce Hollman
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