By Tanner Lambson 

Like food and water, sleep is a fundamental ingredient in the recipe for human survival with enormous health benefits. Regularly getting a full night’s rest – for adults, 7 or more hours – boosts your immunity to disease, helps to reduce stress, improves memory, and can even lower your risk for serious medical conditions. 

But what happens when you don’t get enough sleep? About 1 in 3 adults in the United States is sleep-deprived. Everything from stress to using a phone or other device for too long before bedtime can affect the quality of your sleep. There are also medical conditions that negatively impact sleep, known as sleep disorders. 

“Before the 20th century, snoring was often considered a sign of good quality sleep, when in fact it’s a sign that something bad might be going on," said Samuel A. Taylor, Jr., M.D., M.S., a clinician with the VCU Health Center for Sleep Medicine and an assistant professor in the VCU School of Medicine Department of Neurology. “Today [we know that snoring] might mean you have a sleep disorder, like sleep apnea, which can cause problems for the entire body, including the heart.” 

Although several sleep disorders may be stressful on or unhealthy for your heart, sleep apnea is particularly dangerous. With sleep apnea, your breathing is interrupted which can lead to oxygen deprivation – placing a strain on the heart and blood vessels. Obstructive sleep apnea increases the risk of heart failure by 140%, the risk of stroke by 60%, and the risk of coronary artery disease by 30%.  

We sat down with Taylor to learn more about the relationship between obstructive sleep apnea and heart health, and what treatment options look like. 

What is sleep apnea, and what are the signs and symptoms of it?  

There are two major types of sleep apnea – obstructive sleep apnea (OSA), in which throat muscles relax during sleep to such a degree that the airway is partially or completed blocked, and central sleep apnea (CSA), which happens when the brain doesn’t send the correct signals to the muscles responsible for breathing during sleep.  

OSA is a very common disorder. The National Sleep Foundation did a study several years ago that showed that people have OSA at approximately the same rate as people have type two diabetes. It's the second most common sleep disorder there is, right after insomnia.  

Some common symptoms of obstructive sleep apnea are: 

• Snoring 
• Pauses in breathing during sleep, which might lead to waking up gasping, coughing, or choking 
• Feeling excessively tired and sleepy during the day 
• Awakening with headaches in the morning  

How does obstructive sleep apnea affect heart health? 

We know from many years of research that people who suffer from OSA have an increased risk of developing heart disease, be it heart arrhythmia, heart failure, or coronary artery disease such as heart attack or myocardial infarction. 

That’s because OSA reduces oxygen levels in the body, and when that happens, the body releases stress hormones. Low oxygen levels and high stress hormone levels increase blood pressure, cholesterol levels, and inflammation throughout the body – damaging your heart over time.  

When you are living with untreated OSA, your sympathetic nervous system – which controls your heart rate, blood pressure, and breathing rate – is in a state of over-activation even when you are awake. This also increases your risk for high blood pressure and related diseases. 

Is obstructive sleep apnea preventable? 

There are several things that patients can do to modify their risk factors for OSA, but in some cases it’s completely unavoidable. Some people are predisposed to OSA because of other medical conditions. And while OSA is not a genetic condition in the strictest sense, it's not uncommon for our patients to have multiple family members who may have it.  

OSA is associated with an increased risk in people who are clinically obese. As the instance of obesity has risen in the U.S. and the rest of the world, cases of OSA are expected to rise as well. 

In cases of OSA that are preventable, there are environmental and lifestyle factors that can reduce the risk for OSA. These include: 

Maintaining a healthy body weight. Diet and exercise are very important to overall good sleep quality for all patients. 

Quitting smoking. We know that smoking cessation is important for general health on multiple levels, but there are some studies that have shown that people that smoke also have a higher risk for OSA. 

Treating other breathing-related conditions. Certain conditions like asthma or COPD can slightly increase the risk for OSA, so treating and controlling these conditions can help. 

How is obstructive sleep apnea treated? 

The gold standard treatment for OSA is some form of positive airway pressure therapy, or PAP, with the most common being “continuous positive airway pressure” therapy, or CPAP. But there are other forms as well, such as “bi-level positive airway pressure” therapy, or BiPAP. Today, there are also even more advanced modalities, like adaptive servoventilation (ASV) and average volume-assured pressure support (AVAPS). 

The way that PAP therapy works to control OSA is through use of the positive pressure, which is delivered by a mask attached by a flexible tubing to a CPAP machine. That positive pressure helps to keep the airway open while patients are sleeping so that they don't experience the upper airway collapse and obstruction associated with OSA. 

By the time many of our patients set up their first appointment with us, they may have had signs and symptoms of OSA for many years, but they may not have known what their symptoms meant, or they were minimized in some way. It is important to understand what a sleep disorder looks like, and, if you are experiencing any symptoms of a sleep disorder, to get yourself tested if you are able. 

Read more heart health stories on the Pauley Heart Center Blog

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