Sleep Apnea and Heart Failure

Sleep Apnea and Heart Failure

Sleep apnea is a serious health problem that impacts the heart in many ways. Research on sleep apnea and heart failure is well established, and sleep apnea has been identified by the National Institutes of Health as an identifiable cause of congestive heart failure (CHF), stroke and coronary artery disease (CAD).

Healthy sleep is essential for a healthy life because our quality of sleep affects our overall well-being. Normal sleep is generally composed of two main states: non-rapid eye movement (called non-REM) and rapid eye movement (called REM) sleep. Non-REM sleep makes up about 80% of our sleep and includes the occurrence of hormone release, which is very important to allow the body to function. REM sleep accounts for about 20% of the night and is the stage of “deep” sleep where dreams occur. Sleep apnea interrupts both non-REM and REM sleep. The interruption of both stages of sleep does not allow systems, like your heart, to rest and recover as they normally would.

During sleep, the upper airway collapses obstructing airflow from moving through the airway. Sleep apnea affects about 1 in 5 people. In the U.S. alone, sleep apnea affects 20 million adults and has also been closely linked to high blood pressure, obesity and diabetes. People with sleep apnea stop breathing while they’re asleep, sometimes hundreds of times a night. A bed partner may even witness these gasps that are followed by a coughing sound, which opens the airway again.  Common symptoms of OSA include: snoring, constant tiredness, poor concentration, depression, lack of energy, weight gain or loss and high blood pressure.

Sleep apnea and Heart Failure

·         Approximately 50% of people with heart failure have sleep apnea 

·         Sleep apnea is common in moderate and severe heart failure patients and contributes to worsening outcomes, including increased mortality 

·         Studies have proven that effective CPAP (continuous positive airway pressure) treatment leads to improved heart function and a reduction in enlarged heart dimensions³

Sleep apnea and coronary artery disease (CAD)

·         Approximately 30% of CAD patients have sleep apnea. 

·         CAD patients on CPAP treatment have a lower chance of facing new cardiovascular events (eg, hospitalization and death).^2, 

Sleep apnea and Atrial Fibrilation (increased heart beat)

·         Obstructive sleep apnea affects approximately 50% of all atrial fibrillation patients.⁴

·         AF patients on effective CPAP treatment have a lower risk of AF recurrence than those who are left untreated.³

Treating sleep apnea

The good news is that sleep apnea is easily treatable without surgery or taking pills. The sleep disorder is commonly treated with continuous positive airway pressure (CPAP) therapy. A bedside device gently delivers pressurized air through a small nasal mask or pillows system. This pressure acts like an “air splint” to keep the upper airway open throughout the night. Recent studies show that treating SDB can decrease blood pressure and improve cardiovascular function. 

Conclusion

If you think you or your loved one may have sleep apnea, talk to your family doctor or cardiologist about these symptoms to see if further evaluation is required. If your clinician finds that you have symptoms of sleep apnea, you will be sent to a sleep specialist for an overnight evaluation. If you test positive for sleep apnea, the sleep specialist will write you a prescription for CPAP therapy. This treatment is covered by most insurance.