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Can sleep apnea cause serious effects to my heart?
I am sure that I have sleep apnea. Does that cause serious effects to my heart?
submitted by Martha from Conroe, Texas on 5/8/2013
by Texas Heart Institute cardiologist, Scott Sherron, MD
Martha, I am happy to address this issue since I am board-certified in both cardiology and sleep medicine (a surprisingly unusual combination since there are so many cardiac effects of sleep disorders).
Obstructive sleep apnea causes or worsens high blood pressure, is a common cause of atrial fibrillation, can worsen congestive heart failure and leads to an increase in heart attacks in people who have coronary artery disease. The main mechanism is related to adrenaline. When a person with sleep apnea starts to drift into deeper stages of sleep, they beginning to breathe too shallowly or even briefly stop breathing because of the relaxation of the voluntary muscles that they depend on to keep their airway open. (People without sleep apnea can maintain their airway with involuntary muscles even in the deepest stages of sleep and in REM.) This inadequate breathing leads to hypoxia, a drop in oxygen level. This is a physiologic stress which triggers a release of a small amount of adrenaline which partially wakes them up, allowing deeper breaths. It often does not result in a full arousal and may only cause more shallow sleeping. However, when this occurs over and over throughout the night, it can cause a person to effectively "bob" just under the surface all night, never achieving the full 90 min cycles that provide restorative sleep, leaving them sleepy all day even after 8 or more hours of sleep. Also, the repeated small doses of adrenaline can cause an increase in BP and strain on the heart.
Although, CPAP (continuous positive airway pressure) can seem very difficult at first, it can be a very effective treatment and the results make it worth the difficulty. Other treatment options are available if CPAP fails. Hope this was helpful.
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Updated May 2013