Heart Attacks, Heart Disease and Sleep Apnea
The Relationship Between Sleep Disorders and Cardiovascular Events
Apr 20, 2009
According to the Centers for Disease Control and Prevention, every year, over one million Americans suffer a heart attack. About 450,000 of those are fatal. People know the usual risk factors for heart attacks include smoking, alcohol intake, weight, and a history and/or family history of high blood pressure, high cholesterol or diabetes. But now a new area of research is looking into another link for heart attacks - the relationship between sleep apnea and heart dysfunction.
The Relationship of Heart Attacks, Sleep Deprivation and Sleep Disorders
A major study in Japan showed that long hours at work combined with sleep deprivation can increase blood pressure and heart rates to such an extent that chest pains or a cardiac arrest can result. (“It Has Long Been Known that Shortage of Sleep Can Cause Heart Attacks”, Lorna Duckworth, The London Independent, July 10, 2002.) When further analyzed it was found that those who slept five hours a night or less, or had at least two days a week of insufficient sleep, faced a two-fold to three-fold increased risk of a heart attack. Sleep deprivation and sleep disorders began to be suspected as a very important, yet under-appreciated, causative factor in heart attacks.
Sleep Apnea is a Little Known Cause for Heart Attacks and Stroke
Sleep apnea is a condition where the person stops breathing temporarily for short periods of time, perhaps numerous times throughout the night, because of an obstruction of the airway path. The most common form, obstructive sleep apnea (OSA), is where the tube carrying air to the lungs collapses periodically and blocks the airflow. Most people overlook it and many are not even aware they have the condition or of the significance. While it has previously been suspected of leading to an increased risk for heart disease, it has been hard to prove because of other complicating factors such as obesity.
A recent study further proves the relationship between sleep apnea and heart dysfunction. In the article “Obstructive Sleep Apnoea and its Cardiovascular Consequences” (T. Douglas Bradley, MD, and John Floras, MD, The Lancet, January 2009), it was shown that OSA with repetitive apneas expose the cardiovascular system to cycles of hypoxia and noxious stimuli which can, in turn, cause hypertension, coronary artery disease, arrhythmias, heart failure, and stroke. Men with untreated severe sleep apnea are more likely to have a heart attack.
This new research shows better the relationship between healthy men, men who have simple snoring, and men with treated and untreated sleep apnea and heart attacks. Those with severe and untreated sleep apnea proved more likely to have a fatal or non-fatal heart attack during the ten years of follow up. The study did show that simple snoring on its own is not a risk factor.
Another article, “Sleep Apnea Linked to Night Heart Attacks” (Drugs Information Online, July 22, 2009), further defines the risk. In this article, studies were reviewed including one that showed that sudden death at night is more common for people with sleep apnea. An obvious cause of sudden death is a heart attack, thus, sleep apnea may act as a trigger for night-time heart attacks.
Treatment for Apnea is Essential
Treating OSA lowers blood pressure, and in patients with heart failure tends to improve cardiac function. Data now suggests that treatment of OSA has the potential to diminish risk for heart attacks, whereas people with sleep apnea who refuse treatment have a three-to-four times increased risk of cardiac events.
Treatment of sleep apnea appears to remove the extra risk of heart disease. Therefore, men should take sleep apnea seriously and be proactive to ensure it gets treated.
Resources
American Sleep Apnea Association
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