Experts urge treatment for sleep apnea, as it can worsen heart problems

By American Heart Association News

grandriver/E+, Getty Images
(grandriver/E+, Getty Images)

Can't sleep properly? If you also have a heart condition, or risk factors for one, ignoring the problem could further harm your health, a new scientific statement finds.

Heart doctors should pay more attention to a common sleep disorder that can worsen heart disease but often is unrecognized and undertreated, according to the report from the American Heart Association published Monday in its journal Circulation.

The scientific statement calls for increased screening and greater awareness of obstructive sleep apnea, or OSA, in people with cardiovascular risk factors or conditions.

OSA, characterized by snoring and disrupted sleep, can worsen heart conditions. That can create a cycle in which heart problems then worsen sleep apnea. It also is a risk factor for a heart rhythm disorder called atrial fibrillation, as well as sudden cardiac death.

Advances in treatment for OSA can help but often are overlooked, the report finds.

"Patients report better mood, less snoring, less daytime sleepiness, improved quality of life and work productivity with OSA treatment," Dr. Yerem Yeghiazarians, chair of the report's writing group, said in a news release. He is a professor of medicine and the Leone-Perkins Family Endowed Chair in Cardiology at the University of California, San Francisco.

Screening advances have changed how sleep apnea is diagnosed and treated, he said. Patients no longer need to spend the night at sleep study centers. They can use FDA-approved sleep devices they take home and send back to their doctors for assessment.

And, continuous positive airway pressure, or CPAP machines, are no longer the only form of treatment. Other therapeutic options include positional therapy, weight loss, oral appliances and surgery.

Between 40% and 80% of people with cardiovascular disease also have sleep apnea. Symptoms include snoring, lapses in breathing, fragmented sleep and daytime sleepiness. It affects about 34% of middle-aged men and 17% of middle-aged women.

OSA has been linked to several cardiovascular complications, including high blood pressure, especially when it is difficult to treat; stroke; worsening heart failure and heart disease; Type 2 diabetes; metabolic syndrome; and pulmonary hypertension, a type of high blood pressure that affects the arteries in the lungs and the heart. It also occurs more often in people at high risk for heart attacks.

The report recommends different OSA screenings based on a person's heart condition and its severity.

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