February is American Heart Month. Heart disease is the leading cause of death in the United States, claiming hundreds of thousands of lives each year. One of the precautionary measures people can take to prevent heart disease is to get a proper amount of nightly sleep.
According to David A. Kristo, MD, medical director of the Walter Reed Army Medical Center’s Sleep Disorders Center in Washington, D.C., and a diplomate of the American Board of Sleep Medicine, obstructive sleep apnea (OSA), a sleep related breathing disorder that causes one’s body to stop breathing during sleep, is a precursor to heart disease.
"During American Heart Month, it’s important to remember the implications of sleep on cardiovascular health. Specifically, obstructive sleep apnea is considered a factor in causing or being associated with high blood pressure, heart attacks, stroke, and congestive heart failure," says Kristo.
Untreated sleep apnea has also been linked to memory loss, sexual dysfunction, loss of sex drive, moodiness and depression, diabetes, greater involvement in motor vehicle accidents, falling asleep at inappropriate times, among other serious health, social, and personal issues.
"Treatment of obstructive sleep apnea may improve control of blood pressure and improve nocturnal oxygen levels, which helps in minimizing risks of stroke, heart attack, and heart failure. Additionally, obstructive sleep apnea may cause abnormal heart rhythms which would not be triggered at night with successful treatment of obstructive sleep apnea," Kristo added.
A number of studies have implicated obstructive sleep apnea in the development of heart disease:
- A lack of sleep leads to obesity, which increases the likelihood of developing obstructive sleep apnea. An increased body mass index negatively influences cardiopulmonary capacity in persons with obstructive sleep apnea.
- Obstructive sleep apnea may cause sleep restriction, which has a negative effect on cardiac activity.
- Concentration of plasma cysteine, considered a risk factor for coronary heart disease, increases with sleep apnea severity.
- Persons with congestive heart failure and obstructive sleep apnea commonly report habitual snoring.
- Having obstructive sleep apnea influences both chronotropic and pressoric responses during the exercise test in patients. Obstructive sleep apnea subjects are unable to increase their heart rate in the same proportion as those without obstructive sleep apnea did.
- Intermittent hypoxemia may be an important determinant of sleep disordered breathing-related cardiovascular disease.
Additionally, studies published in recent issues of the journal Sleep link inadequate sleep to heart disease. According to research, daytime sleepiness brought on by obstructive sleep apnea may put one more at risk for cardiovascular problems. Further, people with sleep duration above or below the recommended seven-to-eight hours per night face an increased risk of hypertension, a major predictor for heart disease.
These studies are evidence that sleep plays an important role in helping people live longer and healthier lives, Kristo adds.
Treating obstructive sleep apnea patients with continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BiPAP), or the generic term for any of the various types of positive airway pressure devices, xPAP, may reduce their risk of dying from heart disease.
xPAP is the standard of care for treating moderate to severe cases of obstructive sleep apnea. xPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open, preventing the pauses in breathing that characterize obstructive sleep apnea and restoring normal oxygen levels.
Kristo offers the following tips on how to get a good night’s sleep:
- Follow a consistent bedtime routine.
- Establish a relaxing setting at bedtime.
- Get a full night’s sleep every night.
- Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.
- Do not go to bed hungry, but don’t eat a big meal before bedtime either.
- Avoid any rigorous exercise within six hours of your bedtime.
- Make your bedroom quiet, dark and a little bit cool.
- Get up at the same time every morning.
Those who believe they have obstructive sleep apnea, or another sleep disorder, should consult with their primary care physician or a sleep specialist.
Links of interest
Have you had bouts of insomnia lasting two weeks or more? Do you walk around in a constant fog, feeling sleepy, fatigued, and as though you have no energy? Perhaps you "feel" older than you are, or maybe it’s all you can do to stay awake while driving. If any of that, or similar issues are familiar, or if you snore or have disrupted sleep, even if just a few simple, repeat trips to the bathroom during the night, check out these two online tests to help you get to the root of the issue. While they will not make a diagnosis for you, they will help you, your physician, or, more appropriately, a sleep specialist, find out what’s causing you the problem sleepiness.
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