Sleep Breathing, Stroke and Heart Disease
Up to 10 % of adults have a significant sleep disorder that profoundly worsens the odds of having a heart attack, stroke, or heart failure.
If someone has observed that you snore, or that during your sleep you choke or stop breathing, you owe it to your future health to make certain you don’t have a fairly common condition known as sleep apnea.
In this disorder, the airway closes off partially or fully during your sleep, causing inadequate exchange of oxygen and carbon dioxide in your lungs. For many of us, aging causes the tongue to be more loosely attached to the lower jaw, allowing it to slip back into the throat during repose. As a result of poor airflow, when the circulating blood with insufficient oxygen goes to the heart, it can cause heart arrhythmias or heart muscle asphyxia (angina).
The brain is also disturbed by sleep apnea. First, the brain is aware of a turbulent struggle to get the air in, causing brief arousals and a resultant lightening of the sleep. Then, when lowered blood oxygen reaches particular brain cells, it can cause additional arousals or complete awakening from sleep, leading to a much greater risk of being sleepy during important daytime activities like driving.
Night sweats and frequent urination at night, daytime memory lapses, depression, or poor concentration may also be signs of disordered sleep breathing.
Recent research published in respected medical journals has documented the importance of treating sleep breathing disturbances.
| STROKE
Untreated severe obstructive sleep apnea led to a tripling of the risk for stroke or death over 4 years in a Yale study published in the New England Journal of Medicine last year
HEART FAILURE -
Just last month, a team of cardiologists in Belgium published their important study of the heart functions of people with sleep apnea, before and after treatment.
Even persons without cardiac symptoms had significant worsening of heart size and blood flow, the first signs of heart failure, which reverted to normal after 6 months of treatment for the apnea.
COMBINED CARDIOVASCULAR EVENTS -
The combined risk of fatal and nonfatal heart attacks, strokes, or need for coronary bypass angioplasty procedures was four times greater in patients with severe untreated sleep apnea followed for ten years by a team of investigators in Spain, published in the highly regarded Lancet Medical Journal last year.
What is the reason for greatly increased risk of stroke, heart attack, and heart failure in persons who have sleep apnea? At least one common link is blood pressure. Numerous studies have demonstrated the greater occurrence of hypertension in persons with sleep apnea.
When the apnea is effectively treated, high blood pressure is often returned to normal or at least more easily handled with medication, and the reduction in blood pressure from restoring sleep breathing accompanies a proportionate reduction of risk for heart attack and stroke.
Even persons without high blood pressure are at increased risk of cardiovascular problems if they have sleep apnea. One mechanism is sympathetic nervous system activation. When the brain perceives that blood oxygen levels are temporarily too low, it causes a stress in the sympathetic nervous system that increases the work of the heart at a time when the heart is supposed to be more relaxed during sleep. Also, the lowered oxygen level activates clotting factors in the blood and blood vessels of the heart and brain. Once again, these adverse effects in the sympathetic nervous system and blood vessels are reversed by eliminating the sleep apnea.
Your physician is probably much more aware of the importance of identifying sleep breathing disturbances now than years ago. If you suspect that someone you know may have sleep apnea, encourage him or her to bring the subject up to your physician just when other cardiovascular risk factors like high blood pressure or cholesterol are being discussed. A healthier night of sleep for you is more than just a nice thing .
Steven Scheer, M.D.
Board Certified Sleep Medicine
Medical Director
Sleepcare Diagnostics
The Boardwalk Building
6003 Honore Avenue, Suite 101
Sarasota, FL 34238
941-927-9686
www.snorenomore.com/sarasota
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