Sleep Care

Sleep Your Way to a Healthier Heart

Sleep apnea—a condition in which a person has stopped breathing due to the airway collapsing while asleep—is a concern for an increasing number of individuals each year. It is linked to high blood pressure, obesity, stroke, and diabetes. A person suffering from sleep apnea is also at an increased risk for an accident at work or while driving. One of the more significant effects of sleep apnea is the way it can negatively impact the heart. The disruptions in airflow caused by the airway collapsing lead to fluctuating levels of oxygen in the blood, which can cause the heart to pump irregularly to try and make up for the inadequate oxygen saturations. Direct damage to the heart can also be done. If left untreated, sleep apnea can lead to cardiac arrhythmias, congestive heart failure, and ultimately a heart attack—which may be fatal, or reduce the quality of life for those who survive. Cardiac Arrhythmias An “arrhythmia” refers to a condition in which the heart is beating abnormally. Sometimes it may feel like the heart has just skipped a beat, or there is a brief pause in heartbeats. A person’s heart rate may increase significantly (tachycardia; the heart rate is above one hundred beats per minute) or decrease significantly (bradycardia; the heart rate is below sixty beats per minute). Isolated arrhythmias usually are not problematic for most individuals, although how damaging they can be often depends on a person’s medical history and any concurrent conditions. Periods of sustained arrhythmia can lead to lightheadedness, dizziness, and the heart’s inability to pump blood efficiently. Congestive Heart Failure Congestive heart failure (CHF) is a condition that affects more than five million Americans today and is a leading reason for hospital visits among the elderly. For someone with CHF, the heart fails to pump sufficient blood to the body, which often leads to a fluid build-up in the feet, ankles, and legs known as edema. Fluid build-up can also occur in the lungs (pulmonary congestion)—which can exacerbate the symptoms of an individual already suffering from sleep apnea. Heart Attack Heart attacks occur in more than one million Americans each year. When the heart fails to receive sufficient oxygen—a possible scenario for someone with sleep apnea—the cells of the heart may begin to die. This can result in a part or all of the heart stopping, which may lead to death. If a person suffers a heart attack and recovers, the portion of the heart that died will heal, but it will be scarred. This scarring prevents that part of the heart from stretching to pump blood as effectively as it did before, so the overall efficiency of the heart is reduced. For a person with continued untreated sleep apnea, this is a dangerous condition—particularly as he or she ages. Treatment Fortunately, Continuous Positive Airway Pressure (CPAP) is an effective way to treat sleep apnea for most individuals. This treatment extends into improving the heart-related effects of sleep apnea. A 2003 study that investigated the use of CPAP in patients with both obstructive sleep apnea and heart failure found that

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in addition to having their apnea symptoms resolved, participants who wore CPAP at least four hours during the night

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reduced their heart rate and improved their ability to pump blood effectively.

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