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It is estimated that 15 million people in the United States have sleep apnea.
Heart disease is the leading cause of death in
the United States. When you put these two common
diseases together you find a high rate of sleep
apnea in patients with heart disease. Doctors
have discovered that problems relating to the
heart including angina, congestive heart failure,
and irregular heart beating may be worsened by
untreated sleep apnea.
Obstructive sleep apnea is usually caused by
the tissues in the back of the throat blocking
the windpipe and making it impossible to breath.
In addition, patients with severe congestive heart
failure can stop breathing over and over throughout
the night without obstructing their wind pipe.
Both patterns can lead to dangerously low levels
of blood oxygen and increase the risk for serious
health problems.
In obstructive sleep apnea, the inability to
take a breath sends a panic signal to the brain.
This triggers the brain to release a surge of
adrenaline leading to a big gasping breath. This
routine can occur up to 400 times in a night leaving
the person terribly tired during the day. In addition,
sleep apnea can add to serious health problems
including heart disease! Remember the last time
you were startled or suddenly frightened? Likely,
you could feel your heart beating stronger and
faster due to the release of adrenaline. Not being
able to breath is a similar severe stress. With
severe untreated sleep apnea the release of adrenaline
can occur over 400 times in a night! Adrenaline
raises blood pressure and over time it is thought
that this leads to high blood pressure not only
at night but also during the day. Untreated high
blood pressure can lead to congestive heart failure,
heart attack, and stroke. In addition, treatment
for sleep apnea has been shown to lower blood
pressure in those with hypertension.
Congestive heart failure, cardiac arrhythmia
and coronary artery disease can be made worse
by the nightly struggle to breath and subsequent
release of adrenaline. In patients with heart
failure and sleep apnea, treatment called CPAP
can actually make the heart beat stronger. In
patients with apnea and heart failure, treatment
with CPAP has also been shown to lead to less
serious irregular heart rhythms including atrial
fibrillation and ventricular tachycardia. Of course,
everyone is concerned of heart attack. Untreated
sleep apnea has been associated with an increase
of death in those with known coronary artery disease.
It is still unknown whether treatment with CPAP
can reduce the rate of nocturnal angina and heart
attack. If you have heart disease or hypertension,
ask you doctor about your risks for sleep apnea.
Christian B. Lloyd MD
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