There was a time when the impact of one disease on another was completely overlooked, but, in recent years, the medical community has started to look at the human body as one whole unit. There is strong evidence that a link between heart disease and sleep disorders exists. This is particularly true when you focus on hypertension and heart failure. What the medical community does not know, is if treating sleep disorders can prevent heart disease. If it is possible, then how can cardiologists add sleep disorder evaluations into their practice?
There is mounting evidence that shows the correlation between sleep apnea and heart disease. The connection has not been substantiated, but many professionals are studying the best way to treat one, in order to treat the other.
When studying sleep apnea, it is hard to determine if the cause is obesity, diabetes, a cardiovascular disorder, or if sleep apnea is the precursor. If cardiologists and other clinicians did screenings for sleep disorders related to breathing problems, they would likely find that a substantial number of patients are affected.
The most prevalent form of sleep apnea is known as OSA (obstructive sleep apnea). In roughly 40% of hypertension cases, the patient also has OSA and in 40% of patients with OSA, there is hypertension. These percentages vary depending on certain demographic factors. For example, women who are not obese will have a decreased risk of sleep apnea or OSA.
This extends to the type of heart disease a patient has. For those with atrial fibrillation, there is a 50/50 chance that they will also have sleep apnea. In patients with myocardial infarction, the numbers can rise as high as 60%. These numbers change depending on age, location, gender, and overall health.
Unlike OSA, CSA (central sleep apnea) occurs after the onset of heart problems, most commonly heart failure. From a medical standpoint, CSA is almost exclusive to patients that have suffered heart failure and those that take opioids either medicinally or recreationally. This means that the relationship of OSA to heart disease is likely different than the relationship of heart failure to CSA. Each condition must be given specific and unique parameters.
The differences between CSA and OSA have led many doctors to speculate that CSA is actually an adaptive response brought on by a sickening heart. After having heart failure, the patient’s respiration changes to limit the stress on the heart by reducing the impact of arrhythmia. The pressure put on the heart and the autonomic nervous system by OSA are the main factors that predispose an individual to heart disease. The changes to blood pressure in the large arteries combined with repetitive hypoxia and re-oxygenation put unnecessary stress on the heart.
Many doctors are being encouraged to treat CSA unless there is a reason not to. For optimal treatment to occur, patients must be open about their apnea symptoms so it can be determined if it is OSA/CSA or something else entirely.
Author: Rachael Herman is a professional content writer with an extensive background in medical writing, research, and language development.
© 2020 American Sleep Association.