Treat Your Sleep Apnea if You Want Better Heart Health

Much has been made of the importance of treating obstructive sleep apnea (OSA) to prevent chronic disease.

Chief among these conditions is heart disease, a dangerous byproduct of untreated OSA.

For National Heart Month, which happens every February, let’s take a look at the links between heart disease and OSA.

Heart disease basics

Heart disease isn’t a single disease but a category of heart conditions that include:¹

• Blood vessel diseases
• Heart arrhythmias
• Congenital heart defects
• Heart valve diseases
• Heart muscle diseases
• Heart infections

Types of heart disease

Blood vessel diseases

You’ve likely heard of “hardening of the arteries,” the buildup of fatty plaques in the arteries (atherosclerosis). These deposits can block the arteries, resulting in heart attacks, angina, or stroke. Symptoms include:¹

• Chest pain, tightness, discomfort, or pressure (also known as angina)
• Limb numbness, weakness, or coldness
• Pain in the back, upper abdomen, throat, neck, or jaw
• Shortness of breath

Heart arrhythmias

When your heart beats too quickly, too slowly, or too irregularly, it’s known as an abnormal heartbeat or arrhythmia. Sometimes this happens in the absence of heart disease. However, it’s concerning when heart disease is present. Symptoms include:¹

• Chest pain or discomfort
• Lightheadedness, dizziness, fainting
• Chest “fluttering”
• Shortness of breath
• Racing heartbeat
• Slow heartbeat
• Irregular heartbeat

Heart defects

We’re born with these heart disease conditions, and they’re usually identified soon after birth. Symptoms in children include:¹

• Shortness of breath during feedings
• Swelling in the legs, abdomen, or the face around the eyes
• Pale gray or blue skin color

Some heart defects don’t show until later childhood or adulthood. Symptoms in adults include:¹

• Shortness of breath
• Swelling in the hands, ankles, or feet
• Fatigue

Heart valve disease

Perhaps the most familiar heart valve condition is the murmur, in which the valve that directs blood flow through the heart makes a distinctive sound. With some heart murmurs, the valve still works. But others may signal dangerous problems with leaks, improper closure, or narrowing. Symptoms include:¹

• Chest pain
• Fainting
• Shortness of breath
• Irregular heartbeat
• Fatigue
• Swollen feet or ankles

Heart muscle diseases

Also known as cardiomyopathy, heart muscle disease may start with no symptoms but gradually worsen. As cardiomyopathy advances, symptoms include:¹

• Dizziness, lightheadedness, and fainting
• Breathlessness regardless of activity level
• Irregular heartbeat (rapid, pounding, or fluttering)
• Fatigue
• Swollen legs, feet, or ankles

Heart infections

When the lining around the heart’s inner chambers and valves becomes infected, this qualifies as heart disease. Symptoms include:¹

• Shortness of breath
• Marked changes in the heartbeat
• Fatigue
• Swollen legs or abdomen
• Fever
• Dry or persistent cough
• Skin rashes or spots

How does sleep influence heart health?

Healthy sleep allows the body opportunities to repair itself. Damage to the body happens daily. Damage is rarely acute, like in a car accident. Sometimes, even an emotionally stressful day can cause chemical imbalances in the bloodstream. Sleep is the body’s best chance to rebalance those chemicals. Sleep is also how we fight infection and heal from wounds.

While heart disease can run in families, the Centers for Disease Control and Prevention (CDC) also warns that adults who routinely sleep less than 7 hours a night generally face higher risks for developing heart disease.²

Candidates for poor sleep include people with persistent insomnia, others who willingly (and regularly) get too little sleep, and those with untreated OSA.

OSA and heart disease

OSA, a mechanical disruption of sleep breathing, causes dangerous imbalances in oxygen and carbon dioxide in the bloodstream. Apneas (pauses in breathing) trigger frequent episodes of low blood oxygen. Remember, the heart is a muscle. Muscle tissue requires adequate oxygen to function properly. Apneas place significant strain on the heart.

Also, we awaken following apneas in order to voluntarily breathe, equalizing oxygen and carbon dioxide levels. However, the stress response this requires – a flood of hormones into the bloodstream – elevates blood pressure and heart rate, complicating the body's healing mechanisms.

Atrial fibrillation

A frequent outcome of low blood oxygen related to OSA is “A fib” (atrial fibrillation), a common abnormal heart rhythm. Abnormal heart rhythms are known to lead to sudden death.³

Atherosclerosis

Atherosclerosis frequently occurs in people with OSA who show no other significant risk factors for heart disease.⁴

Leaky heart valves

For those with leaky heart valves, untreated OSA becomes a dangerous risk factor during valve replacement surgery.⁵

Hypertrophic cardiomyopathy

OSA is also extremely common among people with hypertrophic cardiomyopathy (the most common genetic heart disease). Its prevalence ranges between 32 and 71 percent.⁶

Other concerns linked to untreated OSA

Other major cardiac concerns related to untreated OSA include higher risk for heart failure, treatment-resistant high blood pressure, and stroke.⁷

Seeking answers to sleep problems – especially snoring or unexplained daytime fatigue – may do more than help you achieve better sleep. It just may save your life.