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Sleep Apnea and Heart Disease
#1
[parts of this thread were copied from old forum]

Sleep Apnea and Heart Disease

What is the connection between sleep apnea and heart disease?

The connection between sleep apnea and heart disease is evolving very rapidly. People with cardiovascular problems such as high blood pressure, heart failure, and stroke have a high prevalence of sleep apnea. Whether sleep apnea actually causes heart disease is still unclear, but we do know that if you have sleep apnea today, the chance that you will develop hypertension in the future increases significantly.

One of the problems in defining the relationship between sleep apnea and heart disease is that people with sleep apnea often have other co-existing diseases as well.

If you treat people with high blood pressure and sleep apnea, or heart failure and sleep apnea, the measures of blood pressure or heart failure are significantly improved. There is good evidence to think there is a cause-and-effect relationship between hypertension and sleep apnea.

Why does your blood pressure go up when your sleep is disrupted by sleep apnea?

Your blood pressure will go up because when you're not breathing, the oxygen level in your body falls and excites receptors that alert the brain. In response, the brain sends signals through the nervous system and essentially tells the blood vessels to "tighten up" in order to increase the flow of oxygen to the heart and the brain, because they have priority.

The problem is that things that go on at night tend to carry over in the daytime, even when the sleep apnea patient is awake. The low oxygen levels at night seem to trigger multiple mechanisms that persist during the daytime, even when the patient is breathing normally.

How can CPAP (continuous positive airway pressure) reduce the cardiovascular consequences of sleep apnea?

The available evidence tells us that when you treat people with sleep apnea using CPAP, their blood pressure is not only lower at night- it's also lower during the day. That's a very good thing. Moreover, people with atrial fibrillation [a common type of irregular heart beat] with sleep apnea that is appropriately treated have only a 40% chance of coming back for further treatment of their atrial fibrillation. If their sleep apnea is untreated, the chance of a recurrence of atrial fibrillation goes up to 80%. The message to heart patients with sleep apnea is: With treatment of your sleep apnea, your chances of improvement are considerably better.

--Dr. Virend K. Somers is Professor of Internal Medicine in the Division of Cardiovascular Diseases at the Mayo Clinic in Rochester, MN.
This article originally appeared in the Summer 2004 issue of sleepmatters.

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#2
Cutter wrote:
I am one of those individuals who make up the statistics that relates sleep apnea to heart disease. I've had two heart attacks, bypass surgery and enough balloons blown up in my heart to celebrate a five year olds birthday. My cholesterol has never been over 130 and I quit smoking over 40 years ago. Why do the arteries in my heart keep plugging up? I don't know but I'm going to guess it has something to do with sleep apnea. Great post zonk!
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#3
Quote: zonk wrote
The problem is that things that go on at night tend to carry over in the daytime, even when the sleep apnea patient is awake. The low oxygen levels at night seem to trigger multiple mechanisms that persist during the daytime, even when the patient is breathing normally.

Sleepster wrote:
It wouldn't surprise me if this were true of other things too, like anxiety.
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#4
[copied from old forum]

Quote: Cutter wrote
I am one of those individuals who make up the statistics that relates sleep apnea to heart disease. I've had two heart attacks, bypass surgery and enough balloons blown up in my heart to celebrate a five year olds birthday. My cholesterol has never been over 130 and I quit smoking over 40 years ago. Why do the arteries in my heart keep plugging up? I don't know but I'm going to guess it has something to do with sleep apnea. Great post zonk!

lindertw wrote:
This interests me as well... I had a mild heart attack in Dec '10 (38 years old, non-smoker, run 10-20 miles per week, etc.).

I had my post-sleep study appt with another cardiologist in my practice this past week, and he said something that intrigued me - he said during an apnea event my body is in 'fight or flight' mode and the resultant adrenalin dump that my body experiences can cause stress on the heart (my AHI from the sleep study was 35).
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#5
I was just Dx'd w/paroxysmal Atrial fibrillation late summer 2010 most likely secondary to COPD but quite likely exacerbated by insufficient CPAP therapy.

I spent 18 months on CPAP therapy before being switched to Resmed S8 VPAP (bi-level) PAP therapy. And I had mouth leak problems. And aerophagia problems (severe enough I had to discontinue PAP for 2 months and restart at 5 cms EPAP, 10 CMS IPAP pressure (way insufficient) 1 cm at a time for 1 week at a time and build up to 10 cms EPAP pressure, 14 cms IPAP pressure. I even spent time auto titrating BPAP pressures w/the PR S1 BPAP Auto. I got as troublesome- and as good - pressure w/one or the other.

FINALLY reaching my optimum VPAP pressure settings AND w/25 mg Toprol 1 x daily and 225 mg of Rythmol 2 x daily a recent 21 day event monitor verified "normal" sinus rhythm and heart rate control.

My original 30 day event monitor results revealed only two A fib events that I was aware of, but several less serious A fib events and quite a few PVCs and PACs I was not at all aware of.

"We" are considering the Respironics INR Home Test for monitoring and adjusting warfarin dosages. I can't "do" the Pradaxa due to the increased risk of GI bleeds over warfarin.

I've used both the eCardio ER920W event monitor and the CardioNet MCOT event monitor. I much prefered the comfort and convenience of the ER920W event monitor.

My first provided 02 concentrator was an old well-used DeVilbiss 5L that chugged on for 5 years after I got it, then a used InvaCare Platinum, and now a new Respironics EverFlo Q. I'm also provided w/8 E 02 oxgen tanks w/small cart and 8 B 02 tanks w/carry case by my DME provider as well as any other oxygen or PAP therapy supplies I need. They've been very good to me - which I can NOT and will NOT say about my first DME provider!!!!

I recently purchased the SeQual Eclipse 3 portable concentrator out of pocket so I could continue w/my regular 02 therapy and supplies via my insurance. While I do like its convenience (I don't do well w/pulse provided 02) I think I most likely would have liked the Respironics EverGo portable concentrator better.

So there you have my experience w/CPAP, VPAP/BPAP, A fib, event monitors, 02 concentrators and portable 02 concentrators.

Sleep-well


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