By Parrish Medical Center Sleep Disorders Center Manager and Brevard A.W.A.K.E. Coordinator Kristina Weaver, RPSGT
Unlike what many people think, sleep apnea is not just a sleep problem. Sleep apnea is failure to breathe properly during sleep. This means vital organs don’t get the oxygen they need. It is a serious problem, especially for the heart. During sleep, the body should rest. With sleep apnea, the body struggles due to low oxygen levels causing increased stress on the heart.
Lack of Oxygen, Sleep Apnea and the Heart
Because of the lack of oxygen, people with untreated sleep apnea are at a higher risk of developing irregular heartbeats like atrial fibrillation. They also have a higher risk for a stroke and heart attack. In fact, men with untreated sleep apnea have double risk for a stroke.
A few years ago, I did a sleep study on my father. He stopped breathing 41 times an hour and had two episodes of ventricular tachycardia and a seven second sinus pause. These could have been fatal arrhythmias. As I sat there looking at my monitor, I prayed he did not have any more arrhythmias.
Since the arrhythmias were caused by sleep apnea and lack of oxygen, we started CPAP. Once his oxygen levels came up and we treated his sleep apnea, his heart stayed in a normal rhythm. Unfortunately he was in denial and refused any kind of treatment.
At 53 years of age, one year after his study, my father suffered a heart attack in his sleep and passed away. A person with untreated sleep apnea is three times more likely than the normal population to die of sudden cardiac death between midnight and 6 a.m.
How the Heart Works
To understand, let’s think of the way the heart works. The heart has four chambers which make up the right and left sides of the heart. Think of these two sides of the heart as two pumps–the left side of the heart or “lung pump” and the right side of the heart or “body pump.”
The lung pump sends blood from the heart to the lungs to get oxygen. After the lungs oxygenate the blood, it is sent to the body pump. Then, the body pump sends this oxygenated blood to the body.
With sleep apnea, the process to receive oxygenated blood does not happen properly. None of the organs, including the heart, receive the oxygen needed. This puts stress on the heart, causing it to have to work harder. It’s comparable to a person attempting a marathon with no training or conditioning; very dangerous.
This is the reason there is a higher risk of heart failure with sleep apnea. Usually it’s left ventricular heart failure in patients with sleep apnea. Remember, the left side of your heart is your body pump. The body pump works extra hard to move poorly oxygenated blood all the way to the brain and the toes. Since the body pump does not have the oxygen it needs, it has to work even harder. As a result, the heart becomes enlarged and tired and eventually fails.
Men have a 58 percent increased risk of developing heart failure from untreated sleep apnea.
Because the heart has to pump so much harder, blood pressure increases. Medication may help to control high blood pressure, but really it’s just a Band-Aid. Patients with sleep apnea run as high as an 85 percent risk of having blood pressure that is hard to control. A lot of times, sleep apnea is the cause of high
A lack of oxygen to the heart, like a lack of oil to an engine, causes things to misfire and work improperly. The pumps of the heart work from an electrical system. If the electrical system is not getting the fuel it needs, it will begin to fail and have misfires or frayed signals.
Atrial Fibrillation, Sleep Apnea and CPAP
Atrial fibrillation is one of the most irregular heart beats. Atrial fibrillation is a quivering of the atrium, or a bunch of misfires from the top part of your heart. With atrial fibrillation, the blood cannot fully leave the top part of the heart; therefore it can clot in the heart. Eventually those clots may move. They could move to the brain, heart or another part of the body.
It’s critical to treat atrial fibrillation as soon as possible. By simply treating sleep apnea with CPAP we can decrease the risk of developing atrial fibrillation by 70 percent! No medication can do what CPAP can. This shows there is a direct correlation between atrial fibrillation and untreated sleep apnea.
The words “sleep apnea” are under-valued. Sleep apnea not only impacts sleep, it damages the heart. If you have sleep apnea you may feel as though you sleep through the night; you may feel well and rested, but the truth is, your heart will not. ◆