Health Plus Medical Correspondent
Through all this uncertainty of the COVID-19 pandemic, one thing for certain is that sleep is extremely important to the heart as much as it is to the mind and vital organs. If you are one of the many people who toss and turn nightly, you are no stranger to how a sleepless night can affect your motivation, attitude and productivity of your day. However, the ramifications of poor sleep extend far beyond a cranky mood.
Plain old snoring can get a little annoying, especially for someone listening to it. But when a snorer repeatedly stops breathing for brief moments, it can lead to cardiovascular problems and potentially be life-threatening.
It is a condition known as sleep apnea, in which the person may experience pauses in breathing five to 30 times per hour or more during sleep. These episodes wake the sleeper as he or she gasps for air. It prevents restful sleep and is associated with high blood pressure, arrhythmia, stroke and heart failure.
Obstructive sleep apnea (oxygen deprivation during sleep) increases the risk of heart failure by 140%, the risk of stroke by 60%, and the risk of coronary heart disease by 30% according to research from Mayo Clinic.
“The evidence is very strong for the relationship between sleep apnea and hypertension and cardiovascular disease generally, so people really need to know that,” said Donna Arnett, Ph.D., chair and professor of epidemiology at the School of Public Health at Birmingham and the incoming president of the American Heart Association.
Obesity Contributes to Sleep Apnea
One in five adults suffers from at least mild sleep apnea and it afflicts more men than women, Dr Arnett said. The most common type is obstructive sleep apnea in which weight on the upper chest and neck contributes to blocking the flow of air.
Obstructive sleep apnea (OSA) is associated with obesity, which is also a major risk factor for diabetes, heart disease and stroke. Besides obesity contributing to sleep apnea, sleep deprivation caused by sleep apnea can, in an ongoing unhealthy cycle, lead to further obesity, Dr Arnett explained. In OSA the upper airway closes off because the muscles that hold it open lose tone - the more weight, the more loss of tone and the more severe the sleep apnea. Each time the airway closes, there is a pause in breathing.
Listen to Those Snoring Complaints
Often a sleeping partner or roommate of someone with sleep apnea notices it. “It’s really hard to detect if you live alone, unless you go through a sleep study,” Dr Arnett said. People with sleep apnea may be more tired during the day, she said, and therefore prone to accidents or falling asleep.
Getting enough sleep is often a challenge as we try to manage and juggle the responsibilities of life, work, home and school et cetera but the quality of our sleep is even more detrimental to our health than the length of time we sleep. Sleep deprived sufferers typically look at the amount of sleep obtained from night to night as a gauge to measure their sleep health but fail to understand that the quality of sleep is far more important in the long run. The heart, lungs and brain are working less efficiently while asleep in untreated Sleep Apnea.
The relationship between sleep and heart failure is a two-way street.
Sudden drops in blood oxygen levels that occur during sleep increase blood pressure and put strain on the cardiovascular system. A habitual snorer is at risk of Obstructive Sleep Apnea (OSA) and increases their risk of high blood pressure (hypertension) and also the risk of recurrent heart attack, stroke and abnormal heartbeats, atrial fibrillation and cardiac arrhythmias. If you have heart disease, multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death leading to an irregular heartbeat and systemic complications.
Getting Proper Treatment
In a sleep study, doctors count pauses in breathing to determine whether the patient has mild sleep apnea, characterised by five to 15 episodes per hour; moderate sleep apnea, defined by 15 to 30 per hour; or severe sleep apnea, meaning more than 30 each hour. It’s certainly possible to have simple, loud snoring without sleep apnea. But with regular snoring, the person continues to inhale and exhale.
With sleep apnea, the sleeping person tends to have periods when he or she stops breathing and nothing can be heard. The good news is treatment that keeps the breathing passages open and oxygen flowing can yield fast results, Dr Arnett said. “Blood pressure comes down really quite quickly.”
Through treatment known as continuous positive airway pressure, or CPAP, the patient's blood pressure stabilized. The CPAP device involves wearing a mask while sleeping. It keeps air pressure in the breathing passages so they don’t close down.
Tips for a Good night’s Heart Healthy Sleep Regime
Once a thorough assessment is made and treatment ensues, it is also important to create a Heart healthy Sleep Regime.
- Go to sleep at the same time each night, and get up at the same time each morning, even on the weekends.
- Do not take naps after 3pm and do not nap longer than 20 minutes.
- Stay away from caffeine and alcohol late in the day.
- Avoid nicotine completely.
- Get regular exercise, but not within two to three hours of bedtime.
- Do not eat a heavy meal late in the day. A light snack before bedtime is OK.
- Make your bedroom comfortable, dark, quiet, and not too warm or cold.
- Follow a routine to help you relax before sleep (for example, reading or listening to music). Turn off the TV and other screens at least an hour before bedtime.
- Do not lie in bed awake. If you can’t fall asleep after 20 minutes, do something calming until you feel sleepy, like reading or listening to soft music.
- Talk with a doctor if you continue to have trouble sleeping.
