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Is apnea secondary to heart problems.
#1
Hello, I am new to the site. I am a Vietnam vet. disabled with ischemic heart disease, stent and just recently was given a MET-5 heart rating, My cardiologist ordered a sleep study and now I am on a BiPAP. I need some information relating to my heart problems causing my sleep apnea. Can apnea be secondary to heart failure?
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#2
If your heart doesn't beat effectively, blood with oxygen doesn't circulate. That would probably trigger heavier breaths via the body's feedback loops. It might even wake you up if severe enough. Logically, if that happened often enough, you'd feel like crap during the day.
                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#3
Ed, welcome to the forum. Yes. Congestive heart failure produces an easily recognized pattern of periodic breathing and apnea known as Cheyne Stokes Respiration. For some examples of that see this thread http://www.apneaboard.com/forums/Thread-...ead?page=2

For some years, it was thought that leveling out the periodic breathing and apnea from this condition was benefcial, and the use of adaptive servo ventilation was the gold standard to accomplish that. ASV provides breath by breath pressure support to resolve central apnea and hypopnea. Recently, ASV was found to be contraindicated for CHF when the left ventricular ejection factor (LVEF) is less than 45%. http://www.aasmnet.org/articles.aspx?id=5562 As a result of this recommendation, bilevel therapy without ASV, or CPAP has become the recommended therapy. Supplemental nocturnal oxygen is often needed since the Cheyne-Stokes respiration is usually not well controlled by CPAP.

I'm sure you are aware of the connection between Agent Orange exposure and Ischemic Hearth disease, and that veterans that served in Nam are automatically qualified for disability benefits and health care. Thank you for your service and sacrifice. I'm sorry that this condition is affecting you.
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#4
I don't think they really have a definitive answer on that. Heart disease is a huge wad of damage and diseases. A cpap did not prevent the heart attack and deaths of 3 of my relatives. Blood clots caused those. I have a slow heart rate. There is argument back and forth that apnea causes bradycardia or that bradycardia causes apnea. I did not have apnea before the bradycardia, so for me, it's a result, not a cause.

I know my MOM would have benefited from my Dad having a cpap because his snoring was horrible for years. He never stopped breathing however (you could tell this 2 rooms away). After his heart attack, he no longer snored.
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#5
There are many scientific studies that indicate a link between sleep apnea and heart issues and also diabetes. Does sleep apnea "cause" heart issues? Nothing indicates that it does. What is indicated is that if you do have heart issues then untreated sleep apnea can make it worse. There has never been any research that even indicated that treating sleep apnea can prevent a heart attack.

So what happens: with sleep apnea you stop breathing, your O2 drops, your heat tries to pump faster to get O2 around your body, the apnea stops and you gasp for air, your heart says "cool there is now O2 to be had" and starts pumping quickly to get the O2 to your body. With a healthy heart this should not be a problem, however with a compromised heart, these rapid increases in activity can add significant stress. Typically it is probably best to limit stressing your heart (exercise) to cardio workouts that the professionals have recommended and not adding stress while you are asleep and have no control over.

Personally I have a double bypass and 2 stents, so I asked my cardiologist about this issue and he gave one of those Doctors chuckles and said that if my heart was in that bad of shame (45% or less) I would need to sit down and catch my breath after walking across the room, so no this ASV "issues" would not be a problem with me (at least for now).

As for sleep apnea causing you heart problems, I have never heard of that. Accelerating heart issues is possible. Adding additional stress on your heart, yes. From what you have said, I would think that your doctor so far has a good handle on your case. Biggest indicator of that is the "CPAP induced central apnea" as many would miss that.

Your event level is higher than many but I have seen 100+ levels of events per hour.

Pretty sure your CPAP machine is data capable and you should install sleephead free software and take a look at what is going on while you are sleeping. Look for CSR breathing. watch your apnea count.

Welcome to the club
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#6
I'm thinking in response to the other comments, that apnea very likely causes or contributes to an enlarged heart which creates other problems.
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#7
https://www.thoracic.org/patients/patien...-heart.pdf
A nice talk about sleep apnea and the heart and yes indeed the heart can enlarge from sleep apnea and decrease after SA treatment. There very specific things that SA can effect and others that it does not seem to effect.
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#8
My SA didn't really become fully evident to me until after I had my triple bypass. This could have been because my heart was now functioning normally and as a result the SA became more obvious. I only remember the fatigue affects after the bypass.
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