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[Treatment] PAP effects on the heart
#1
I know there are positive cardiac benefits associated with treating sleep apnea with PAP.

PAP pressures are measured in cm-H2O; and 1 cm-H2O = 0.73mm-Hg.
So, are we not increasing the pressure that the right ventricle must work against; and increasing the filling pressure into the left atrium?

If the above is true, have there been any studies on how this impacts cardiac health?
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#2
I don't see any way that the air pressure can reach the heart. There is no direct pathway from either the windpipe or the esophagus to the heart. The pressure may affect the lungs and can certainly affect the stomach (i.e., aerophagia), but I don't see how the pressure can affect the heart.
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#3
Considering average blood pressure is 120/80 mmHg, even if it were to transmit directly to the blood pressure a 0.73 mmHg per cmH20 still falls within normal blood pressure variation during the day (at 20 cmH2O it only amounts to ~14 mmHg).

Perhaps if you're already borderline hypertensive (high blood pressure), it could be an issue, but I think the cardiac benefits of CPAP far outweigh what minor impacts PAP induced pressure could have on blood pressure.
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#4
The heart probably does have to pump a bit harder and increase pressure to deal with the increased pressure in the lungs. I suspect it's pretty insignificant vs. the damage done by untreated apnea.

There was a study that claimed that hypoxia associated with untreated sleep apnea increases the vascularization of the heart which gives some benefit sometime when a blood vessel in the heart gets blocked. Treating the apnea with CPAP actually does reduce this effect. I believe the overall benefit to the heart far outweighs this risk, because apnea tends to increase blood pressure and stress.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#5
My doctor told me that my heart was working harder during periods of apnoea sleep than it was when I was just seated or lying down awake and rested. He said the strain on the heart during the periods of apnoea was quite deadly and in the old days, before apnoea was really studied and treated with machines, many a middle-aged and older person died in their sleep due to a prolonged apnoea episode. They were the folks we used to say "died the best way"...or..."they went peacefully in their sleep". Well NO THANKS! I prefer breathing! Smile My doctor said that if anything my heart health would improve once I was on a machine and took some dietary precautions as well.

I wouldn't worry about machine pressure hurting you heart. As someone pointed out...air pressure in the lungs cannot leach through to the heart.
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#6
Makes sense, Stroppy. High blood pressure is a key symptom of untreated sleep apnea.
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#7
See the following link for a list of cardiac problems associated with untreated sleep apnea. Some of these associations have shown to be causal in nature (for some of them, the causal link has not been established): http://www.medscape.com/viewarticle/721684
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#8
(08-07-2014, 09:09 AM)NickDanger Wrote: Makes sense, Stroppy. High blood pressure is a key symptom of untreated sleep apnea.

I was diagnosed with severe sleep apnoea and I am overweight and any time the doc took my blood pressure pre-apnoea diagnosis it was always normal so for me my blood pressure was not indicative of apnoea.

The doc also explained to me that an apnoea episode triggers the release of adrenalin in the blood stream.
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