Your Sleep and Heart Disease: The Beat Goes On

Published March 26, 2019

According to the American Heart Association (AHA), heart disease and stroke kill one in every 3.7 men and one in 2.4 women – the number 1 and number 3 killers of women.

But did you know that poor sleep quality and the lack of sleep could increase the risk of developing heart disease?

The most common sleep disorder associated with heart disease is obstructive sleep apnea (OSA). It is estimated that OSA affects 2 – 4% of the population. OSA is an abnormal breathing pattern during sleep associated with a partial collapse of the airway. These episodes may lead to complete collapse of the airway and the cessation of breathing, called apnea.

Obstructive sleep apnea (OSA)

OSA is characterized by snoring, pauses in breathing, waking up from sleep with a choking or gasping sensation, and multiple unexplained arousals from sleep. Other symptoms of OSA include fatigue, headaches in the morning, excessive urination at night, episodes of moodiness or irritability, and other symptoms that compromise quality of life. With episodes of apnea, oxygen levels abruptly drop to dangerous levels during sleep. This lack of oxygen causes the heart rate to slow down and then causes the heart rate to speed up when breathing resumes. For those with untreated OSA, apnea episodes can occur hundreds of times a night and significantly compromise sleep and cardiac function. The repeated lack of oxygen and changes in heart rate can lead to significant cardiac disease. Hypertension, coronary heart disease, cardiac arrhythmias, stroke and sudden cardiac death have all been associated with OSA.

The relationship between OSA and hypertension

The Sleep Heart Health Study, a multi-center cohort study implemented by the National Heart Lung & Blood Institute, correlated the consequences of cardiovascular disease with untreated OSA. In the study of over 6,000 participants, the severity of OSA was linked to the severity of hypertension. And, when OSA was treated, blood pressure also became lower.

The lack of oxygen that occurs during OSA reduces the amount of blood flow to the heart. This places increased demand on the heart, resulting in increased cardiac stress called ischemia. Increased cardiac ischemia can lead to a heart attack, and untreated OSA is associated with increased risk of death from coronary artery disease. The biomarker, C – reactive protein, may be elevated in cases of coronary artery disease and OSA, further supporting the evidence linking OSA and heart disease.

Home sleep testing

Home sleep apnea testing allows OSA to be easily diagnosed at home. During this test, information is collected using different sensors, which detect breathing during sleep. This information is then reviewed by a sleep doctor and a treatment plan is undertaken. For people with comorbid medical conditions or complex sleep disorders, monitored polysomnography is performed in a sleep laboratory.. For most people with OSA, continuous positive airway pressure (CPAP) is the “gold standard” therapy and is highly effective in treating OSA and eliminating OSA symptoms. Other treatment options, such as oral appliance therapy, upper airway surgery or hypoglossal nerve stimulation, may be considered as alternative therapies to treat OSA.

Treating OSA will improve sleep quality, enhance cardiac function and lower blood pressure.

So get better sleep — your heart will love you for it!