Sleep Apnea Heart Disease and Congestive Heart Failure: Is There a Link?
When your partner snores all night every night it’s more than annoying. It’s dangerous if the cause is sleep apnea.
This sleeping disorder affects 22 million Americans. It’s a condition where something blocks a person’s airway. That blockage stops them from breathing.
Someone with sleep apnea may stop breathing 5 to 30 times an hour. Each time it happens the sleeper wakes up gasping for air.
Disrupted sleep can lead to cardiovascular issues. Problems include high blood pressure, arrhythmia, stroke, and heart failure. That’s on top of the risks associated with sleep deprivation.
Does sleep apnea cause congestive heart failure? The Heart Association links sleep apnea and cardiovascular disease.
The good news is sleep apnea treatment helps lower blood pressure and the risk of heart disease.
Before you push someone out of bed for snorting and snoring, learn how to identify sleep apnea. Proper treatment could stop their noisy nighttime breathing.
Sleep Apnea Disorder
There are two kinds of sleep apnea. Both types cause daytime sleepiness, fatigue, and a reduced ability to function.
Most people experience obstructive sleep apnea (OSA). The less common type is central sleep apnea (CSA).
Complex sleep apnea is a combination of OSA and CSA.
Obstructive Sleep Apnea
Obstructive sleep apnea occurs when something blocks the upper respiratory airways. With the air flow cut off the brain signals the respiratory system to react. Breathing resumes with snorts, gasps, and body jerks.
Those sounds and motions awaken the sleeper. Waking many times throughout the night causes sleep deprivation.
The reason for OSA varies. Causes range from collapsing throat muscles to the tongue falling backward. Enlarged tonsils and adenoids can narrow the upper airway enough to cause OSA.
People with endocrine disorders are susceptible. High and low hormones produce changes in the mouth and throat that affect breathing.
Obesity is a common cause of OSA. Extra weight in the chest plus fat deposits in the neck can block the flow of air. When extra weight weakens muscles that hold the upper airway open OSA becomes severe.
Continued sleep deprivation may lead to more obesity. Obesity is a major risk factor for heart disease and stroke.
Central Sleep Apnea
The second and less common type of sleep apnea is central sleep apnea (CSA). It occurs when the brain doesn’t tell the diaphragm to contract and expand.
Problems in the brain stem cause CSA. Breathing impulses come from the brain stem. A brain stem stroke could produce CSA.
People with heart disease often have CSA. Someone with CSA doesn’t make as much noise as an OSA sufferer.
Sleep Apnea and Heart Disease
When sleep apnea causes you to stop breathing the oxygen levels in your blood drop. That drop wakes your brain enough for it to send a message to your nervous system.
The brain tells your nervous system to constrict blood vessels. This increases the flow of oxygen to your heart and brain. But, constricting blood vessels also increases your blood pressure while you sleep.
Part of your body’s response is to release the stress hormone, epinephrine. When sleep apnea happens over and over again the adrenaline levels in the body stay high. This can cause high blood pressure.
It’s normal for blood pressure to go down ten to twenty percent during sleep. Yet, people with sleep apnea have a ten to twenty percent increase in blood pressure.
The problem is higher blood pressure during sleep creeps into daytime. People with sleep apnea often experience higher blood pressure all the time.
High blood pressure contributes to heart disease, stroke, and other medical issues.
Congestive Heart Failure
Congestive heart failure happens when your heart can’t fill up with blood or pump it to the rest of your body. The decrease in blood flow means your body can’t function as it should.
Fluid collects in ankles or legs causing fatigue. If swelling affects leg arteries it’s painful.
Fluid in the lungs produces fatigue and shortness of breath.
Most often it’s previous heart attacks that damage the heart muscles enough to cause failure. But, there’s evidence sleep apnea connects to heart failure.
Congestive heart failure is one of the main causes of death in sleep apnea sufferers. In fact, 47% to 83% of cardiovascular disease patients have sleep apnea.
Sleep apnea is as serious as heart failure. It can increase blood pressure, decrease ventricular function, and cause diabetes. It also increases pulmonary artery pressure.
All the side effects of sleep apnea contribute to congestive heart failure. Not treating sleep apnea increases the risk of dying from heart disease.
Heart Disease and Congestive Heart Failure Affect Your Sleep
CSA, the less common form of sleep apnea, occurs in people with heart disease.
Heart disease makes people retain sodium and water. Doctors theorize the excess fluid enters the lungs at night.
Fluid in the lungs wakes the person up with shortness of breath. In this case, CSA is a result of having heart disease.
People with atrial fibrillation and older adults are at risk for CSA. Treatment involves close management of the underlying disease.
Symptoms of Congestive Heart Failure
Heart failure is a gradual, progressive disease. Symptoms may take years to appear.
Signs of heart failure may appear after physical activity. As the disease progresses, symptoms last longer.
Here are some common warning symptoms that show heart failure:
- Difficulty Breathing
- Shortness of Breath
- Swollen Legs, Ankles, Feet, and/or Abdomen
- Weight Gain From Water Retention
- Coughing That Includes Blood
- Coughing at Night or When Lying Down
- Fatigue and Weakness
If you experience any of these warning signs, contact your doctor.
Prevention is critical. Medication or surgery can reduce or stop symptoms, but the damage to your heart remains.
Treatment of Congestive Heart Failure
If you think you have symptoms of heart failure call your doctor right now. Schedule an appointment to check your situation.
Sleep apnea develops in people with cardiovascular disease. And as noted above, CSA occurs most often in patients with heart failure.
If you have sleep apnea, tell your doctor. Sometimes, heart failure is a side effect of a serious disorder. You and your doctor must find and treat the original problem.
Treatment options for heart failure include:
- Continuous Positive Airway Pressure (CPAP)
- Supplementing Oxygen
- Optimizing Heart Failure Treatment
People with obstructive sleep apnea should reduce their weight. They should stay away from alcohol and sedatives. Alcohol and certain medications encourage pharyngeal airway collapse.
Weight loss and abstaining may reduce the severity of heart failure and OSA.
Everyone with hypertension, angina, heart failure, and atrial fibrillation needs a treatment plan.
Once heart disease occurs, treatment includes drugs and surgery. Those interventions won’t influence the severity of your sleep apnea.
You may find your heart failure condition improves with the treatment of sleep apnea. Lifestyle changes may improve sleep apnea and your heart at the same time.
Effective Treatments for Congestive Heart Failure and Sleep Apnea
Let’s look at several effective treatments for OSA. Once oxygen is flowing through open airways they can breathe through the night.
Continuous Positive Airway Pressure (CPAP)
The first is a bedside machine that provides continuous positive airway pressure (CPAP). It creates a steady stream of air through a face mask.
CPAP keeps air pressure in the airways. That prevents the back of the throat from collapsing and obstructing airflow.
Some people have trouble sleeping in the mask. Other patients report they feel better than ever. There are several mask designs making it easier to find one that works for you.
Research indicates CPAP treatment for OSA improves heart function. It lowers the risk of cardiovascular problems.
Patients at risk for heart disease who used CPAP lowered their blood pressure. It reduced both nighttime and daytime blood pressure.
Another option for people with sleep apnea is a mouthpiece. The mouthpiece pulls the jaw forward to help the airway stay open.
Some people prefer a mouthpiece. They feel a CPAP machine dries out their nasal passages. A mouthpiece won’t cover your nose or dry it out.
You can buy a standard or custom fit mouthpiece. Either one eliminates the need for tubes and a mask.
An oral device is smaller, less obvious, portable, and lightweight. They travel well.
Some mouthpiece users experience dry mouth, while others encounter excessive drool.
Your dentist can make adjustments to a standard mouthpiece. Or, he can make a custom-fit mouthpiece for you alone.
A third option is an adjustable boil and bite mouthpiece. You heat the device then mold it to your mouth while it’s malleable.
Both CPAP and oral devices are effective for people with mild to moderate OSA.
If getting a decent night’s sleep is a struggle, try these ideas:
- Limit Alcohol Consumption. Too much alcohol interferes with sleep. It’s a sedative that wears off. Keep alcohol intake to one drink for women; two drinks for men.
- Avoid Caffeine Before Bed. Caffeine stays in your body for hours. Don’t drink it close to bedtime.
- Get Regular Physical Activity. Be active throughout the day so you’re tired at night. Don’t exercise right before bed. Activating your adrenaline can keep you awake.
- Create a Bedtime Routine. Put away your electronic devices. Take a soothing bath. Dim the lights. Drink caffeine-free tea.
Sometimes, weight loss and the elimination of alcohol and meds is enough to improve sleep.
Each person is different. That’s why it’s important to consult with a sleep disorder expert. A sleep specialist can determine if there’s an underlying cause for sleep apnea.
Do You Have Sleep Apnea?
Pay attention if your sleeping partner notices unusual breathing or loud excessive snoring. Other clues include daytime sleepiness and constant fatigue.
Older adults and people with cardiovascular disease shouldn’t be sleepy all the time. Talk to a doctor if you fall asleep at unsuitable times or are prone to accidents. It could mean you have sleep apnea.
It’s possible to be a loud snorer without sleep apnea. A heavy snorer continues to inhale and exhale. A person with sleep apnea has periods when breathing stops, and there’s no sound.
An overnight sleep study is the best way to pinpoint the problem.
Get a Sleep Study
A sleep study is the best tool for diagnosing sleep apnea. A sleep disorder expert counts the number of pauses in breathing. This discerns the seriousness of the situation.
People with mild sleep apnea have five to 15 episodes each hour. Moderate sleep apnea has 15 to 30 episodes per hour. Severe sleep apnea occurs when breathing pauses more than 30 times each hour.
During a sleep study electrodes attach to your head and chest. The electrodes send information to a central station. Sleep disorder experts interpret the data.
A sleep study assesses your risk of sleep apnea and heart disease. A sleep disorder specialist identifies sleep apnea and any coexisting or contributing conditions.
Many insurance plans cover the cost of a sleep study. It may be expensive, but the medical costs for treating heart disease are much higher.
Don’t Wait to Talk to Your Doctor
Early diagnosis and treatments like continuous positive airway pressure (CPAC) therapy are successful. Proper care can treat sleep apnea and related symptoms.
Talk to your doctor if you’re concerned about sleep apnea. Discuss any related health risks like congestive heart failure. Your primary care physician can order a sleep study if needed.
Early treatment of conditions like sleep apnea can prevent problems like heart disease.
Visit our website to learn more about sleep disorders. While you’re there check out our resources on how to stop snoring.
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