Is your Heart at Risk? Obstructive Sleep Apnea and Cardiovascular Health
Each February, people across the country recognize American Heart Month. During this time, we are encouraged to pay attention to the risk factors for heart disease and make heart-healthy lifestyle changes. Because heart disease is the leading cause of death in the United States, according to the American Heart Association, it is a subject worth taking seriously. While women are more likely to be affected by the disease, it impacts men as well.
Sleep Apnea and Heart Health
One significant relationship the American Heart Association wants us to take note of is that between cardiovascular disease, blood pressure and obstructive sleep apnea (OSA). OSA is a condition characterized by complete and partial airway obstructions, which can occur when the tongue and muscles relax during sleep, the lower jaw falls back toward the throat or the airway becomes blocked. A typical sequence of OSA occurs when a person stops snoring and is silent for seconds or minutes. The body’s oxygen level drops and the blood pressure rises. The heart is forced to beat faster, causing the pulse rate to increase. The brain may cause the body to jerk in an attempt to wake the sleeper so breathing will resume. The silence may end with a loud snort, cough or gasp. This causes the sleeper to wake briefly and begin breathing. Once asleep again, the muscles relax and the airway becomes blocked, cutting off the airway again. This cycle can occur hundreds of times per night.
The connection between OSA and heart disease is evolving rapidly. In an interview with Dr. Virend K. Somers, the National Sleep Foundation notes that those with cardiovascular problems such as high blood pressure and heart failure have a high incidence of sleep apnea. While the connection between the conditions is not completely clear, those treated for OSA generally see improvement in their heart health as well. It seems both less sleep overall and disruption of sleep may be to blame. Dr. Somers explains that when a person stops breathing during an apnea, the body’s oxygen level falls and alerts the brain. The brain then “tells” the blood vessels to tighten in order to increase flow of oxygen to both the brain and the heart. As a result, blood pressure increases. Though this problem occurs during sleep, it appears to carry over into the day, leading to chronic high blood pressure in people with OSA.
Additionally, there is a connection between increased rate of atrial fibrillation (an irregular heart beat) and OSA. The National Sleep Foundation notes that patients suffering from both conditions whose sleep apnea was treated had only a 40% chance of coming back for treatment of their atrial fibrillation while those whose OSA was untreated had an 80% chance of recurrence of their atrial fibrillation.
Finally, a 2013 study for the American Journal of Respiratory and Critical Care Medicine is the first to link OSA severity with early heart damage that could lead to future heart attack. While previous studies have linked OSA to increased rate of cardiovascular disease, this is the first to show a causal relationship between the two.
Treating Obstructive Sleep Apnea
While the connection between cardiovascular disease and OSA is still not fully understood, it is evident that treatment of OSA can lead to improved heart health. If you are experiencing symptoms of heart disease or high blood pressure as well as those of OSA, such as snoring, choking and gasping during sleep, and daytime sleepiness, you may want to consider asking your physician for a sleep study. In a sleep study, doctors will monitor your pauses in breathing to determine whether or not you have OSA and if so how severe it is.
Treatment options for OSA include lifestyle changes, surgery, Continuous Positive Airway Pressure (CPAP) and Oral Appliance Therapy. While CPAP is one of the most common treatments for OSA, Oral Appliance Therapy has proven to be an effective, scientifically-based treatment alternative that patients may find more comfortable and easier to use. The purpose of the appliance is to hold the jaw in a position that allows the airway to remain as open and firm as possible during sleep. Oral appliances are similar to athletic mouth guards but less bulky and completely non-invasive. Oral sleep appliances are covered by most medical insurance plans and Medicare.
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- Other Lifestyle Changes to Improve OSA
- Weight Loss
- Stopping Smoking
- Sticking to a Consistent Sleep Schedule and Routine Changes in Sleep Position
- Avoiding Caffeine or Heavy Meals
- Avoiding Alcohol