Sleep Apnoea and Heart Health

Can sleep apnoea affect your heart health? Studies say it can. This is especially important because sleep apnoea is becoming more of a common disorder nowadays. It can lead to complications such as excessive daytime somnolence and cognitive impairment, as well as cardiovascular and metabolic morbidity. This is why experts are very careful in controlling its causes.

The heart is especially affected by sleep apnoea. There is growing evidence that untreated sleep apnoea can lead to cardiovascular diseases, i.e. hypertension, coronary artery disease (CAD), cerebrovascular disease and heart rate, conduction disorders and excess mortality. This is especially prevalent among older patients especially those 70 years and up.

So how does sleep apnoea affect health specifically? Here are some points:

• OSA causes myocardial as well as arterial damage. Untreated OSA might, therefore, promote the progression of cardiac disease, resulting in heart failure and increased mortality in patients with heart failure.

• Sympathetic excitation may be the cause of systemic arterial hypertension in OSA. Other studies have confirmed elevated catecholamine levels both in plasma and urine of OSA patients and also a significant fall with CPAP therapy.

• There is an evident link between OSA and the development of atherosclerosis and associated diseases. This has been supported by numerous studies demonstrating impaired endothelial function and signs of early atherosclerosis, such as increased carotid intima-media thickness in OSA and improvement with effective CPAP therapy

• OSA-related repetitive episodes of hypoxia and re-oxygenation can lead to increased production of reactive oxygen species which can promote oxidative stress. There may be increased lipid peroxidation as a result along with endothelial dysfunction in OSA.

• OSA is also associated with glucose and lipid dysfunction.

• OSA is associated with increased prevalence of type 2 diabetes and higher HbA1C-levels in non-diabetic patients. 

• Dyslipidemia is prevalent among OSA patients. However, an independent association between OSA and increased levels of total cholesterol, low-density lipoprotein and triglycerides is not yet clearly proven. CPAP therapy may have a positive effect on lipid profile though more studies are needed to defend this.

Keeping in mind these facts, sleep apnoea should be treated immediately. Cardiovascular disease can lose many lives and sadly, sleep apnoea is a precursor of heart disease.

Reference:

Lévy P, Ryan S, Oldenburg O, Parati G. Sleep apnoea and the heart. Eur Respir Rev. 2013 Sep 1;22(129):333-352.

Image  Courtesy of stockimages / freedigitalphotos.net