sleep heart

Snoring: a serious risk factor for heart disease

by Barry Bittman, MD

If you believe 8 hours of night time sleep and a 1-hour mid-day nap are healthy and restorative, you may be right. Yet if you or your partner are snoring and fatigued during the day, there’s a lot more you need to know.

While we’re all aware of the fact that high cholesterol, smoking, diabetes and high blood pressure are obvious risk factors for heart disease, few of us ever think about what medical scientists term “obstructive sleep apnea” or OSA.

The term “apnea” refers to a temporary suspension of breathing. Basically, there are 3 types. The first, OSA, is a condition that results in snoring when air passages are blocked or obstructed during sleep. The second and far less frequent type is called “central sleep apnea” and results from failure of brain signals to trigger breathing. The third, “mixed sleep apnea” and is a combination of the first two.

The focus of our discussion today is OSA, a condition that is more widespread than we’d expect. While it occurs in both sexes and at any age, most sufferers are men over the age of 40. According to the National Institutes of Health, approximately 12 million Americans are affected. The problem is that most people are unaware of the seriousness of the condition and its potential consequences.

The most likely cause of OSA is the collapse or sagging of tissues at the back of the throat that interferes with air flow. It can occur in any position, but more typically develops when a person sleeps on his/her back. Some of the factors that lead to OSA include obesity, smoking, heavy drinking, allergies or enlarged tonsils/adenoids.

It’s been well-established that sleep apnea can lead to diminished memory, headaches, impotence and high blood pressure. In a previous column, I also noted the increased risk for job-related injuries and motor vehicle accidents.

Yet it’s also important to realize that OSA dramatically increases the risk of coronary artery disease and resultant heart attacks by three-fold. This recently-discovered finding by Swedish researchers was based upon a study of 62 patients with heart disease (44 men and 18 women) compared to a matched group without heart disease.

According to researcher, Dr. Yuksel Peker at Skovde Central Hospital in Sweden, “Our study strongly suggests that this sleep disorder which is common may be nearly as important as diabetes mellitus in increasing the risk of coronary heart disease, and may be more important than high cholesterol or high blood pressure in this group of patients.”

With this in mind, how can we tell if we’re likely suffering from OSA? The answer is revealed by answering 4 basic questions:

Do you snore on a regular basis?

Does your bed partner notice pauses in your breathing during sleep?

Do you awaken at times gasping for breath?

Do you awaken feeling tired and remain fatigued during the day?

If your answer to these questions is “yes,” it’s time to bring this issue to your doctor’s attention. If OSA is suspected, you may be referred to a sleep center where a proper diagnosis can be established. The test of choice is termed, “polysomnography” and is commonly referred to as a “sleep study.” This painless and non-invasive procedure is performed by a respiratory technician who uses a computer to monitor brain waves, eye movements, heart function, muscle activity, bodily movements, breathing patterns and the amount of oxygen in your blood stream. You are monitored while sleeping in a comfortable bed with wires connected via surface skin sensors which relay information to a specialized computer.

After a night in the sleep lab, (a setting that resembles a comfortable bedroom) the technician reviews your data and produces a comprehensive sleep report, actually a computer-generated series of graphs and tables that show the doctor exactly what happened during your stay in the lab¾ whether or not sleep apnea occurred and how often it was noted.

Based upon this information, a treatment approach is developed to meet your individual needs. In next week’s column, we’ll discuss logical treatment options that can help you or a loved-one enjoy a safe and healthy night’s sleep. Until then, remember that it’s up to you to take the first step by bringing this matter to the attention of your doctor. Pleasant dreams¾ Mind Over Matter!