Sleep Apnea, Snoring and Heart Related Diseases

Man Snoring while wife looks concerned.

Snoring can be an annoying disturbance to your sleep, but it could have greater consequences than interrupting you or your partner’s sleep. Researchers have identified a link between snoring and heart related diseases, estimating that untreated obstructive sleep apnea (OSA) may increase risk heart disease mortality by up to five times.

Sleep Apnea and Heart Disease

What is sleep apnea?

If you snore, you don’t necessarily have sleep apnea. Snoring happens when tissues in the back of your throat can relax and partially block the passageway. It’s estimated that about 90 million Americans experience snoring.

Sleep apnea, however, is estimated to impact about 20% of the general population, with about 80% of those people undiagnosed. OSA is characterized by repeated pauses in breathing and occurs when the upper airway is partially or fully obstructed. This leads to sleep interruptions and an overall decrease in oxygen intake. 

What are some causes of sleep apnea?

OSA does not typically have a single cause and rather results from a combination of genetic, health and lifestyle factors. Often, OSA can appear on its own and without any signs or symptoms. Genes are thought to influence the development of OSA by affecting the function of nerve cells, breathing regulation, immune system inflammatory response, sleep cycle and appetite. They can also affect the development of tissues in the head and face so that some people have larger tonsils or adenoids that might obstruct the upper air passages. 

Research has also that 60-70% of individuals with OSA are also obese, indicating that obesity is a main cause. Studies argue that excess fatty tissue in the head and neck constricts airways and that visceral fat can prevent the respiratory system from fully expanding and relaxing.  

What is heart disease?

Heart disease refers to a variety of conditions. Usually, heart disease is used to refer to coronary artery disease (CAD). Other conditions include heart attack, arrhythmia, heart failure and stroke. There are many other heart related diseases

What’s the link between sleep apnea and heart related diseases?

Research suggests that sleep apnea is responsible for about 38,000 heart disease deaths yearly. Sleep apnea leads to sleep deprivation, which can increase sympathetic activity. Aside from sleep loss, sleep apnea also affects intrathoracic pressure changes, sleep arousal, hypoxemia and oxidative stress, which all likewise increase sympathetic activity. Increased or overly sustained sympathetic activity can lead to hypertension and vascular inflammation. Individuals with severe OSA are at a higher risk for coronary heart disease, congestive heart failure and stroke. 

Hypertension

While both OSA and cardiovascular disease are linked to hypertension, which is higher than normal blood pressure, studies show that OSA represents an independent risk factor for hypertension. Approximately 40% of OSA patients experience hypertension. Hypertension increases the risk for heart failure, heart attack and stroke. 

Obesity

Obesity has been shown to trigger the onset of sleep apnea in many cases and may be the most significant predictor. Among patients with sleep apnea, 60% to 90% of them are obese. The severity of sleep apnea increases as patients gain excessive weight. Obesity is directly linked to heart related diseases and cardiovascular risk factors. As body mass index (BMI) increases, so too does blood pressure, bad cholesterol and inflammation, which likewise increases the risk for heart related diseases. 

Diabetes

Evidence shows that OSA is linked to the development of type 2 diabetes. When OSA increases sympathetic activity, the increase impairs blood glucose levels, so that many individuals with sleep apnea also have increased insulin resistance. Those with type 2 diabetes are at a greater risk for developing heart related diseases. 

High Cholesterol

High cholesterol is a known risk factor for the development of coronary artery disease. While it is unclear whether high cholesterol causes sleep apnea or vice versa, the two conditions are often correlated. Studies show that patients with OSA demonstrate greater levels of HDL dysfunction than control patients. In some cases, treatment of sleep apnea was shown to improve the condition of high cholesterol. 

When To See a Doctor

Untreated sleep apnea can have major consequences on your short and long-term health. If you’re experiencing signs and symptoms of sleep apnea, it might be time to see your doctor.

Signs and symptoms include:

  • Excessive daytime sleepiness
  • Loud and frequent snoring
  • Apneas (pauses in breathing)
  • Insomnia
  • Issues with memory or focus
  • Changes in libido
  • Emotional distress

Treatments for sleep apnea

You can make some efforts to alleviate sleep apnea symptoms on your own, such as by sleeping on your side or making lifestyle improvements. When it comes to medical assistance, treatments for sleep apnea are usually dependent on the severity of your condition. Common treatments include:

  • Continuous positive airway pressure (CPAP). This is a machine worn during sleep to eliminate snoring, breathing disturbances and drops in oxygen saturation. 
  • Weight loss. Weight loss to an individually ideal BMI may help to reduce symptoms of sleep apnea. 
  • Oral appliances. Certain oral devices can be positioned in the mouth to prevent obstruction of the air passages. 
  • Lifestyle changes. Changing exercise, reducing alcohol consumption and quitting smoking can help some cases of sleep apnea.
  • Surgery. Some surgical techniques can be used to help keep air passages unobstructed during sleep. 

Are you an excessive snorer and think you might have sleep apnea? Consider seeing your doctor to help improve your sleep and overall health.

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