Sleep Apnea Hurts Your Heart
Unlike what many people think, sleep apnea is not just a sleep problem. Sleep apnea is failure to breathe properly during sleep. This means vital organs don’t get the oxygen they need. It is a serious problem, especially for the heart. During sleep, the body should be resting. With sleep apnea, the body struggles due to low oxygen levels causing increased stress on the heart.
Lack of Oxygen, Sleep Apnea, and the Heart
Because of the lack of oxygen, people with untreated sleep apnea are at a higher risk of developing atrial fibrillation. They also have a higher risk for a stroke and heart attack. In fact, men with untreated sleep apnea have double the risk for a stroke.
A few years ago, I did a sleep study on my father. He stopped breathing 41 times an hour and had two episodes of ventricular tachycardia and a seven second sinus pause. These could have been fatal arrhythmias. As I sat there looking at my monitor, I prayed he did not have any more arrhythmias.
Since the arrhythmias were caused by sleep apnea and lack of oxygen, we started CPAP. Once his oxygen levels came up and we treated his sleep apnea, his heart stayed in a normal rhythm. Unfortunately he was in denial and refused any kind of treatment.
At 53 years old, one year after his study, my father suffered a heart attack in his sleep and passed away. A person with untreated sleep apnea is three times more likely than the normal population to die of sudden cardiac death between midnight and 6 a.m.
How the Heart Works
Let’s think of the way the heart works to explain this. The heart has four chambers, two atrium and two ventricles, that contract to pump blood. I think of the heart as having two pumps made up by these four chambers.
The left side is the body pump and the right side is the lung pump. The lung pump sends blood to the lungs to get oxygen. After the lungs oxygenate the blood, it is sent to the body pump. Then, the body pump sends this good, oxygenated blood to the body.
With sleep apnea this process to receive good, oxygenated blood does not happen properly. None of the organs, including the heart, receive the oxygen needed. This puts stress on the heart, causing it to have to work harder. Essentially it’s comparable to a person attempting a marathon with no training or conditioning. It is very dangerous.
This is the reason there is a higher risk of left ventricular heart failure in patients that have sleep apnea. The body pump works extra hard to move poorly oxygenated blood all the way to the brain and the toes. The left side of the heart becomes enlarged and tired.
Men have a 58 percent increased risk of developing heart failure from untreated sleep apnea. Because the heart has to pump so much harder, blood pressure increases. Medication may help to control the high blood pressure, but really it’s just a band-aid. Patients with sleep apnea run as high as an 85 percent risk of having resistant hypertension.
A lack of oxygen to the heart, like a lack of oil to an engine, causes things to misfire and work improperly. The pumps of the heart work from an electrical system. If the electrical system is not getting the fuel it needs, it will begin to fail and have miss-fires or frayed signals.
Atrial Fibrillation, Sleep Apnea, and CPAP
Atrial fibrillation is one of the most common arrhythmias. Atrial fibrillation is a quivering of the atrium, or a bunch of miss-fires from the atrium. What happens when the atrium quivers and does not effectively pump? Blood sits in the bottom of atrium and starts coagulating or clotting. Eventually those clots may move. They could move to the brain, heart or another part of the body.
It’s critical to treat atrial fibrillation as soon as possible. By simply treating sleep apnea with CPAP we can decrease the risk of developing atrial fibrillation by 70 percent! No medication can do what CPAP can. This shows there is a direct correlation between atrial fibrillation and untreated sleep apnea.
The words “sleep apnea” are under-valued. Sleep apnea not only impacts sleep, it damages the heart. A patient may feel as though they sleep through night; they may feel well and rested, but the truth is their heart does not.
As sleep technologists we can save lives. It’s essential to understand the correlation between sleep apnea and the heart. These are patients coming into our labs with untreated sleep apnea. These untreated sleep apnea patients are 3 times more likely to have sudden cardiac death. It could be in your sleep center. Learn to recognize arrhythmias. Be prepared, practice and have a plan in case a patient codes.
It’s crucial that your lab has an AED and everyone knows how to use it. Learn arrhythmias and make sure your report them. If you need help learning your arrhythmias check out this new learning resource:
Cardiac Abnormalities: Patient Based Learning (PBL) Format:
This is an outstanding learning resource for anyone seeking additional education on cardiac arrhythmias.