Obstructive sleep apnea can contribute to a number of medical conditions, with heart disease among the more serious.

Left unmanaged, sleep apnea has been shown to make the following heart problems worse:

  1. Atrial Fibrillation, or Irregular Heartbeats
  2. Coronary Artery Disease
  3. Heart Failure

Compounding matters, millions of Americans are suffering from sleep apnea without a proper diagnosis or plan of attack to treat the problem. Without this in place, heart problems stemming from sleep apnea have a much higher risk of impacting your life and causing life-threatening damage. Sleep apnea, according to one study, is responsible for nearly 40,000 cardiovascular deaths in the U.S. each year.

Let’s look at how sleep apnea impacts the heart, as well as how CPAP (continuous positive airway pressure) treatment has been shown to drastically improve these heart conditions.

How Sleep Apnea Affects the Heart

Sleep apnea occurs when the upper airway collapses or is blocked during sleep. There are numerous signs of this sleep disorder, several associated with heart conditions, and although being overweight significantly contributes to sleep apnea, it also impacts those of a healthy weight.

Related: Other Associated Health Risks of Sleep Apnea

Hypopnea, a partial blockage of the airway, often heard as a snore (although not always) causes dozens of sleep arousals during the night and leads to poor sleep. Sleep apnea stymies oxygen flow into the body, forcing your heart to work harder during the night to pump oxygenated blood cells to different parts of your body.

To counteract the lack of oxygen flow, your body releases epinephrine, a stress hormone that’s also known as adrenaline, and norepinephrine, the main awake neurotransmitter in the brain. Over the long term, this is damaging to the heart because the release of both epinephrine and norepinephrine can lead to high blood pressure.

Sleep Apnea and Atrial Fibrillation

Obstructive sleep apnea has been shown to put people at a higher risk of atrial fibrillation, or an irregular heartbeat. Atrial fibrillations can lead to multiple health issues, including stroke, heart failure, and other heart complications.

Here’s how it works: Due to the uncommon pressure sleep apnea puts on your chest, you are forced to suck in air aggressively through a narrower throat. At the same time, you’re sucking blood back into the chest faster, which tricks your heart into thinking it’s overloaded. This leads to the release of atrial natriuretic peptide (ANP) in the kidney, which blocks the right atrium and can spur the disruption of the conduction system. This is how atrial fibrillation is caused.

One study, looking at 10 years worth of participant data from about 8,200 Canadians, showed sleep apnea was a “significant” independent predictor of whether someone would suffer from atrial fibrillation.

Overall, people who suffer from sleep apnea are four times as likely to have atrial fibrillation.

Coronary Artery Disease

Coronary Artery Disease is the most common type of heart disease. It can be severely damaging to those who suffer from it, and it contributes to more than 360,000 deaths each year in the U.S., according to the C.D.C.

Coronary Artery Disease develops when the arteries — the major blood vessels that deliver blood, oxygen and nutrients to the heart — are damaged. This typically involves plaque, or cholesterol deposits, building up in your arteries, which leads to a smaller pathway for blood to flow. The issue is compounded by sleep apnea, which spikes blood pressure and leads to more friction against the artery walls — ending up in more plaque developing to cover ruptures in its lining.

Ultimately, Coronary Artery Disease decreases blood flow to the heart and can cause serious health problems. Coronary Artery Disease symptoms include shortness of breath and chest pain. As plaque develops, the disease becomes worse and can cause heart attack or heart failure.

Heart Failure

Research has shown sleep apnea can increase your risk of heart failure by 140%. This is due, in large part, to an increase in heart rate and blood pressure, as the heart works to pump oxygenated blood through constricted arteries.

Heart failure, also known sometimes as congestive heart failure, is a critical issue that occurs when the heart isn’t able to pump blood as efficiently as it needs to. Coronary artery disease and hypertension, or high blood pressure, can contribute to heart failure, as they weaken the heart’s ability to pump blood to different parts of the body.
Symptoms of heart failure include:

  • Upper body pain
  • Fatigue
  • Shortness of breath
  • Irregular heartbeat
  • Swelling of body parts like the feet and legs

Heart failure is a widespread problem in the US. Approximately 6.5 million Americans suffer from it. Approximately one out of eight deaths in the US, or more than 12%, include heart failure as a contributing cause each year. Sleep apnea makes this problem worse.

If you suffer from any of the symptoms listed above, it’s important to get evaluated to either rule out sleep apnea as a contributing cause or to get diagnosed and treated.

Treating Sleep Apnea with CPAP Helps Combat Heart Disease

Seeking help for sleep apnea has also been shown to pay major dividends when it comes to fighting heart disease.

CPAP machines are often the best way to tackle sleep apnea, as they help to increase air pressure to the throat and counteract airway blockages. By removing these blockages, your body holds back on releasing norepinephrine while you sleep, helping to reduce blood pressure and make it easier for the heart to pump oxygenated blood throughout the body. That’s the key way CPAP can positively affect heart health: by removing the catalyst for many of the heart problems people with sleep apnea suffer from.

Research indicates CPAP use is strongly connected to improved heart health. One study from 2018 looked at more than 40,000 participants who developed sleep apnea in Europe. The researchers found CPAP treatment had a profound impact on heart failure, especially for senior participants. Study participants who were 60 or older and did not seek CPAP treatment had a 38% higher risk of heart failure compared to those who did use machines.

Another study, looking at the connection between sleep apnea and the heart, found CPAP treatment led to a 28% drop in the risk of developing Coronary Artery Disease. CPAP’s impact on atrial fibrillation is even more dramatic, with research indicating those using CPAP machines were 42% less likely to develop an irregular heartbeat than people with sleep apnea not seeking treatment.

The connection between sleep apnea and heart disease is real, but so is the link between treating sleep apnea and seeing significant reductions in your risk of heart problems.

DISCOVER HOW SLEEP APNEA RAISES BLOOD PRESSURE

Please look at our easy-to-use Sleep Quiz if you’re worried sleep apnea is blocking you from getting a good night’s sleep.

If you’re ready to discover how a sleep specialist can help you, contact Sleep Centers of Middle Tennessee today and we can get you set up for better sleep.

 

 

References

Girardin, Jean-Louis, et al. (2008). Obstructive sleep apnea and cardiovascular disease; role of the metabolic syndrome and its components. Journal of Clinical Sleep Medicine. 4(3): 261-272. Retrieved on Feb. 11, 2020 from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2546461/#__ffn_sectitle

Kendzerska, T., et al. (2018). Sleep apnea increases the risk of new hospitalized atrial fibrillation: a historical cohort study. Chest. 154(6): 13030-1339. Retrieved on Feb. 11, 2020 from: https://www.ncbi.nlm.nih.gov/pubmed/30243978

Author unknown. (2003). Obstructive sleep apnea and heart disease. American Journal of Respiratory and Critical Care Medicine. Volume 188, part 1-2. Retrieved on Feb. 11, 2020 from:
https://www.thoracic.org/patients/patient-resources/resources/obstructive-sleep-apnea-and-heart.pdf

Holt, A., et al. (2018). Sleep apnea, the risk of developing heart failure, and the potential benefits of continuous Positive Airway Pressure (CPAP) Therapy. Journal of the American Heart Association. 22:7-13. Retrieved on Feb. 11, 2020 from: https://www.ncbi.nlm.nih.gov/pubmed/29934418

Mandal, Swapna, et al. (2018). Obstructive sleep apnea and coronary artery disease. Journal of Thoracic Disease. 34:S4212-S4220. Retrieved on Feb. 11, 2020 from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6321892/#__ffn_sectitle

Tung, Patricia, et al. (2016). Atrial fibrillation and sleep apnea: considerations for a dual epidemic. Journal of Atrial Fibrillation. 8(6): 1283. Retrieved on Feb. 11, 2020 from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5089463/