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Sleep Apnea Can Be Really Bad For Your Heart

By Matthew Epstein, MD, FCCP, FAASM

Sleep apnea is defined as recurrent episodes of narrowing or blockage (obstruction) of the air passage in the back of the throat during sleep. These apneas may occur anywhere from a few times per hour to more than once a minute in extreme cases.

Sleep apnea is highly prevalent, and may affect up to 25% of the middle-aged population. Unfortunately, the majority of those suffering from sleep apnea remain undiagnosed.

Sleep apnea often leads to repetitive disruptions in sleep throughout the night, leaving sleep apnea sufferers with excessive daytime sleepiness. Equally important, sleep apnea may cause numerous adverse health consequences as a result of the severe stress that occurs with each episode of apnea.

Cardiovascular disease, which includes hypertension, coronary artery disease, and stroke, is one of the most important medical conditions in our society.  Cardiovascular disease affects a large percentage of the population, results in enormous costs for evaluation and treatment, and is a major cause of suffering and death. Sleep apnea is increasingly recognized to be an important and treatable risk factor for the development of cardiovascular disease.

Sleep apnea may be an important risk factor in the development of hypertension (high blood pressure), especially for those with moderate to severe sleep apnea. Treatment of sleep apnea has been shown to improve blood pressure.

There is growing evidence that sleep apnea contributes to the development of coronary artery disease.

Untreated severe sleep apnea is associated with a high risk of both non-fatal and fatal heart attacks and stroke. Sleep apnea may also worsen pre-existing coronary artery disease. A study from the Mayo Clinic found that sleep apnea increases the chance of having a heart attack during sleep. Treatment of sleep apnea may reduce the risk of heart attack or stroke.

Sleep apnea is a well-established cause of abnormal heart rhythms (arrythmias). Approximately 50% of patients with atrial fibrillation are found to have sleep apnea, and treating sleep apnea in these patients greatly improves the chance of successfully treating the heart arrhythmia.

Sleep apnea may weaken the heart muscle’s pumping ability, leading to congestive heart failure. Studies have shown that treating underlying sleep apnea in patients with this condition can significantly strengthen the heart muscle.

Clearly, sleep apnea is an important risk factor in the development of cardiovascular disease. Patients with cardiovascular disease should be screened by their doctor for underlying sleep apnea.

 

Matthew Epstein, MD, FCCP, FAASM

Associate Medical Director of the Atlantic Health Sleep Centers, Board Certified in Sleep Medicine, Internal medicine, Pulmonology and Critical Care Medicine.