Sleep Apnea Sleep Disorders Sleep Study

Cardiac Death Increased By Sleep Apnea

Cardiac death increased by sleep apnea

A to Z Sleep

Published on Tuesday, 25 June 2013 17:56

A moderate case of obstructive sleep apnea can significantly increase a person’s risk for sudden cardiac death, according to a study published in theJournal of the American College of Cardiology.

“The prevalence of obstructive sleep apnea in Western populations is high and will likely only continue to grow given the obesity epidemic and direct relationship between obesity and sleep apnea,” said Apoor Gami, MD, MSc, FACC, lead author of the study and a cardiologist at Midwest Heart Specialists – Advocate Medical Group in Elmhust, Ill.

It has been widely reported that sleep apnea can lead to a number of heart conditions, including high blood pressure, atrial fibrillation and heart attacks. Researchers in this study examined the relationship between sleep apnea and sudden cardiac death, building off of their prior study that found people with sleep apnea more frequently died suddenly from cardiac causes during the hours of 10 pm to 6 am, which is the least likely time for sudden cardiac death in the general population.

The 10,701 subjects were followed for an average of 5.3 years for incidents of resuscitated or fatal sudden cardiac death. In that time, 142 patients experienced sudden cardiac death, with the most common predictors being a patient aged 60 years, having 20 apnea episodes an hour and having a lowest oxygen saturation level of below 78%.

Low oxygen saturation occurs when air does not flow into the lungs when a sleep apnea patient is sleeping and as a result the patient’s blood oxygen levels drop. The study showed that a drop to below 78% increases that patients risk of sudden cardiac death by 80%.

The study clarifies that sleep apnea patients’ risk of sudden cardiac death does not simply shift from daytime hours to nighttime hours but that their overall risk of sudden cardiac death is higher than people without sleep apnea.

“Treating sleep apnea in one person can improve the quality of life of both bed partners and may have the added benefit of helping to prevent cardiovascular disease,” said Virend K. Somers, MD, PhD, FACC, senior author on the study and a professor of medicine at Mayo Clinic College of Medicine in Rochester, Minn. “If the spouse sees the bed partner stop breathing repeatedly during sleep, this is an important clue that he or she probably has sleep apnea.”

Sleep Apnea Sleep Disorders

What is Sleep Apnea?

Sleep apnea is the temporary pause in breathing due to the blockage of the upper airways during sleep. These brief gaps in breathing result in many sleep interruptions each hour, dramatically affects the quality of sleep.

Different types of sleep apnea include:

  • Obstructive Sleep Apnea (OSA)
  • Central Sleep Apnea (CSA)
  • Mixed Sleep Apnea (MSA)

What is Obstructive Sleep Apnea?

It is a common sleep disorder with a mild to severe effect on you health and lifestyle.  OSA involves partial or complete collapse of the airway during sleep.  It can occur hundreds of times per night in severe cases.  OSA is created by the muscles in the throat relaxing around your airway narrowing it while you are     sleeping.  It’s much like a straw being pinched in the middle & no fluid is allowed to pass. Once the patient has limited or a completely blocked airway the oxygen will begin to drop as well until the brain senses the patient to breathe once again. The sleeping brain senses the breathing difficulty & increases the effort to breathe.  The increased effort awakens the brain, which signals the throat muscles to become active & open the airway. Each occurrence of this cycle interrupts the     patient’s sleep architecture & prevents the patient from attaining a solid sleep period that the body requires for refreshment.

What is Central Sleep Apnea?

Central sleep apnea is a disorder in which your breathing repeatedly stops and starts during     sleep. Central sleep apnea occurs because your     brain doesn’t send proper signals to the     muscles that control your breathing — unlike obstructive sleep apnea, in which you can’t breathe normally because of upper airway obstruction. Central sleep apnea is less common, accounting for fewer than 5 percent of sleep apnea cases. Central sleep apnea may occur as a result of other conditions, such as heart failure and stroke. Sleeping at a high altitude also may cause central sleep apnea.

What is Mixed Sleep Apnea?

Mixed sleep apnea is a combination of obstructive & central sleep apnea.  The patients apnea will begin central  & within seconds the brain connects to the respiratory  system & then the respiratory system begins to function, but the airway will still be blocked.

Signs & Symptoms of all Sleep Apneas

  • Snoring
  • Witnessed episodes of gasping or “not breathing during sleep”
  • Excessive Daytime Sleepiness that prevents a healthful daily function
  • Irritiability & depression
  • Morning headaches
  • Hypertension with an increased risk of stroke & heart disease

What Causes Different Types of Sleep Apnea?

  • Smaller than normal jaw
  • Large tongue
  • Enlarged tonsils
  • Excessive tissue in back of throat or surround the airway (such as a large neck)
  • Obesity (excessive tissue in neck & structure of mouth)
  • Tissue weakness related to aging
  • Alcohol, sleeping pills & tranquilizers
  • Spinal Cord Damage
  • Opiate Medications
  • High Altitude Sleeping
  • Congestive Heart Failure
  • Stroke

Treatment Options for Sleep Apnea

Depending on the cause of a patient’s sleep apnea will determine the treatment.  Such as if the patient has mild sleep apnea & is overweight, a weight loss regimen may be recommended & patient be retested following weight loss.  Cognitive Behavioral Therapy (CBT) could be implemented for patients with the causes stemming from alcohol or medications.

Some of the most effective & more common treatments are:

  • CPAP Therapy (Continuous Positive Airway Pressure)
  • BIPAP Therapy (Bi-Level pap)
  • ASV Therapy (Auto Servo Ventilation)
  • Oral Appliances (which are 50% effective with mild diagnoses)
  • Surgery (nasal operations, UPP (uvulopalatoplasty), UPPP (uvulopalatopharyngoplasty)
  • Maxillomandibular Advancement (cutting of jaw bones)
  • Somnoplasty (frequency energy waves shrinking the upper airway tissues)

There are many different therapy options for different types of sleep apnea so please talk to your doctor & discuss which option will benefit you the best.