Your Sleep Problems Now Can Signal Heart Trouble Later

How an uncommon form of sleep apnea is linked to heart arrhythmia later
Your Sleep Problems Now Can Signal Heart Trouble Later

Researchers have long known a link between a common form of sleep apnea — a sleep disorder in which breathing is briefly and repeatedly interrupted — and cardiovascular problems such as high blood pressurearrhythmia, stroke and heart failure. But older men who have a different, less-common kind of sleep apnea are more likely to develop heart problems later, research shows.

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Heart arrhythmia

The study looked at the two types of sleep apnea – obstructive and central.

Obstructive sleep apnea (OSA) is the most common form of sleep apnea and is believed to affect nearly 15 million individuals in the United States alone. OSA occurs when your upper airway is completely or partially blocked during sleep. When that happens, your diaphragm and chest muscles work harder as the pressure increases to open the airway. Breathing usually resumes with a loud gasp or body jerk. These episodes can interfere with sound sleep, reduce the flow of oxygen to vital organs, and cause heart rhythm irregularities.

Central sleep apnea (CSA) is a less-common sleep disorder. CSA occurs when your brain fails to signal your muscles to breathe because of instability in the respiratory control center. CSA gets its name from being related to the functioning of the central nervous system. Central sleep apnea is often caused by medical problems and conditions that affect the brain stem.

In the study, researchers followed a group of older men for a period of six and a half years and found that most of the men who had CSA later developed heart arrhythmia, or atrial fibrillation.

While previous studies looked for a relationship between OSA and atrial fibrillation, this study demonstrates a connection between CSA and heart problems, says Reena MehraMD, MS. Dr. Mehra was a lead investigator on the team that conducted the research.

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“In this study, we also sought to look at these relationships and, interestingly, found that not so much obstructive sleep apnea, but rather a different kind of sleep apnea, was associated with development of atrial fibrillation,” Dr. Mehra says.

Future marker

Sleep apnea in general is more common in men than in women and more common in older adults.

“These data support that central apnea appears to somehow be a marker of future development of this arrhythmia,” Dr. Mehra says. “Whether treating that sleep apnea reduces that risk of atrial fibrillation development remains to be seen.”

Previous, but somewhat limited, studies have shown a positive association between sleep apnea treatment and reducing the recurrence of abnormal heart rhythms associated with it, Dr. Mehra says.

Treatment options

Some ways to control sleep apnea include:

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  • Use continuous positive airway pressure (CPAP). This is the standard treatment for sleep apnea, in which you wear a mask over your nose and/or mouth while sleeping. A machine gently pushes air through the mask to keep your airway from closing. Dr. Mehra says CPAP is reliably effective for OSA, and also can be effective for CSA. However, other treatments, such as more advanced versions of PAP therapy, supplemental oxygen or medications may be needed for the best treatment of CSA, Dr. Mehra says.
  • Lose weight by eating a more nutritious diet, reducing caloric intake and exercising regularly if you are overweight or obese. After you lose weight, talk to your doctor about a repeat assessment of your sleep apnea.

Be sure to see your doctor if you have symptoms of sleep apnea, Dr. Mehra says.

“The most important thing to do, if you have any of those symptoms, is to see your physician immediately,” Dr. Mehra says. “Heavy snoring and daytime sleepiness are good clues for obstructive sleep apnea, but you usually need to talk to a sleep specialist or have a sleep study performed to properly diagnose the condition.”

The symptoms of CSA are a bit less straightforward, but may involve a sense of disrupted sleep and sleep maintenance insomnia, Dr. Mehra says.

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