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Sleep Apnea

Sleep apnea is the most potentially life-threatening of all sleep disorders. During sleep apnea, the sleeper actually stops breathing for a few seconds. These brief, but significant, interruptions in breathing can happen hundreds of times in a single night. Because sleep apnea robs the brain and other vital organs of oxygen, the results can be quite severe, including:

  • Heart problems, such as hypertension, heart attack and sudden death
  • Excessive daytime sleepiness (which carries additional safety hazards)
  • Symptoms of depression
  • In women, interruptions of the normal menstrual cycle
  • Frequent nighttime urination

What Causes Sleep Apnea?

Sleep apnea occurs when the pharynx - the tube that carries air from the mouth to the lungs - collapses at the base of the tongue. This is due to negative pressure that is created when a person inhales. This closing of the pharynx can be compared to the way a paper straw collapses when a thick beverage, such as a milkshake, is drawn through the straw.

Normally, the airway stays open even when a person inhales. However, in people who experience sleep apnea, the airway closes up when the sleeper breathes in. Each time the airway closes, the person stops breathing, depriving the body of oxygen. The body's natural reflexes wake the sleeper up, and he or she begins breathing again.

This cycle can repeat itself dozens - even hundreds - of times per night. Most of the time, the person is not even aware of these episodes, but has trouble staying awake during day because of the fitful sleep he or she experiences.

Treating Sleep Apnea

By far, the most effective approach to treating severe sleep apnea is to use a technique called CPAP - continuous positive airway pressure. The CPAP machine consists of a unit that generates air and a mask that the patient wears during sleep. The unit produces a steady stream of air that blows through the mask and against the base of the pharynx, keeping it open throughout sleep. In the vast majority of cases, CPAP immediately and completely eliminates sleep apnea.

Minor cases of sleep apnea can sometimes be cured when the patient loses weight and/or avoids sleeping in a particular position that makes it easy for the pharynx to close. Some patients wear a special dental appliance that keeps the tongue forward in the mouth. At other times, surgery is required to open up the airway.

Click here for information on how a sleep study helps to diagnose sleep apnea and other sleep disorders. 

Sleep Apnea and the Heart

Sleep apnea alone is a serious condition. However, severe sleep apnea can have a significant impact on the heart, making it more important than ever to diagnose and treat the condition. There can be a range of dangerous effects on the heart as a result of sleep apnea, including:

  • Changes in heart rhythm
  • High blood pressure
  • Hypertension (high blood pressure in the vessels that run from the right side of the heart, into the lungs, and back to the left side of the heart)
  • Myocardial ischemia (lack of oxygen to the heart muscle)
  • Heart failure.

Sleep Apnea and Coronary Artery Disease

There can be even more damage to the heart in people who have both sleep apnea and coronary artery disease - blockage of the vessels of the heart. Because of the blockage, it is already difficult to get oxygen-rich blood to part of the heart. However, when sleep apnea deprives the blood of oxygen, even less oxygen eventually reaches the heart muscle. Because of the energy, in the form of oxygen, that the hard-working heart requires, this lack of oxygen can cause severe damage.

You can think of the red blood cells as a "bucket brigade" of sorts. If the "buckets" - the cells - are filled to capacity with oxygen, the heart muscle can receive the full benefit of each cell's oxygen supply. But if the cells are filled, say, just 50 percent, less oxygen is reaching the heart. This lack of oxygen is called myocardial ischemia. In severe cases, myocardial ischemia can cause dangerous heart rhythms, chest pain and sometimes even death.

Who's at Risk?

As with all sleep disorders, everyone is at risk, in varying degrees, of the "one-two punch" of sleep apnea and heart disturbances. However, not all sleep disturbances cause heart damage. For example, heavy snoring doesn't necessarily result in heart damage, if the level of oxygen in the blood remains at a healthy level. Only a diagnosis from a physician can tell you for sure if you at risk for heart problems. There are, however, a number of factors that may put an individual at more risk for heart disturbances, including:

  • Being male
  • Smoking
  • Obesity
  • Diabetes
  • Chronic lung disease
  • Existing coronary artery disease

Again, it is important to talk with your personal physician about any concerns you have regarding sleep apnea and/or heart disturbances.