Sleep Apnea and Cardiovascular Disease

After examining years of emerging research,  the American Heart Association added sleep in 2022 as its 8th habit for a healthy heart.   It recognized that poor sleep and sleep disorders impact our cardiovascular health.  

Individuals with OSA are at a higher risk of developing AFib. The intermittent hypoxia and fluctuations in intrathoracic pressure associated with OSA can lead to structural and electrical changes in the heart, promoting arrhythmias like AFib. Women have worse symptoms of AFIB and worse outcomes (stroke risk, stroke severity, and all-cause mortality).

OSA contributes to the development of hypertension due to repeated episodes of oxygen desaturation and arousal during sleep, leading to sympathetic nervous system activation. This persistent elevation in blood pressure increases the risk of cardiovascular events.

There is a notable prevalence of sleep apnea among patients with heart failure. The presence of sleep-disordered breathing can exacerbate heart failure symptoms and negatively impact prognosis.

OSA is linked to a higher incidence of stroke. The condition's impact on blood pressure, endothelial function, and inflammatory pathways contributes to this elevated risk.

1. Discuss the quality and quantity of your sleep with your cardiologist

2. Ask for a referral to a sleep physician with the intention of adding this dimension to an integrative medicine approach

3. Make sure you get a copy of your sleep study

4. Discuss results with both the cardiologist and sleep physician

5. Ensure your chosen treatment addresses both improving the quality of your sleep as well as reducing the number of sleep-disordered breathing events down to as close to 5 per hour (ideally).

6. Don't be discouraged when you need to keep making adjustments until you get adjusted.

7. Get support from other sleep apnea patients who have been able to adjust to treatment

1. American Heart Association adds sleep to 8 essential habits for a healthy heart.  American Heart Association https://newsroom.heart.org/news/american-heart-association-adds-sleep-to-cardiovascular-health-checklist

2. Sleep apnea and atrial fibrillation.Healthline https://www.healthline.com/health/atrial-fibrillation/sleep-apnea-and-afib

3. Sleep apnea and hypertension.Cleveland Clinic https://consultqd.clevelandclinic.org/exploring-the-connection-between-sleep-apnea-and-cardiovascular-disease

4. Heart failure and sleep apnea. Cleveland Clinic Journal of Medicine https://www.ccjm.org/content/86/9_suppl_1/10

5. Stroke and sleep apnea.American Heart Association https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000988