HEART DISEASE: The Risks of Untreated Sleep Apnea Dr. Andrew Swiatowicz February is American Heart Month, a time to raise awareness about heart disease and how we can prevent it. Heart disease is the leading cause of mortality in America, responsible for over 25% of all deaths each year. If left untreated, heart disease can result in heart attack, stroke, aneurysm, and high blood pressure. Most people are aware of the main causes of heart disease, like a poor diet, sedentary lifestyle, high blood pressure, obesity, stress, and smoking. But many people are surprised to learn their sleep — or lack thereof — can have a huge impact on their heart, too. Obstructive Sleep Apnea (OSA) is associated with obesity, which is also a major risk factor for 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. 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. What is Sleep Apnea? Sleep apnea is a medical sleep disorder in which a person has pauses in breathing, or shallow breathing during sleep. Obstructive sleep apnea (OSA) is the leading type of sleep apnea. Obstructive Sleep Apnea is caused by blockage of the upper respiratory airways in which either the throat muscles collapse, the tongue falls back into the airway, or enlarged tonsils and/or adenoids impede air flow. When your airway becomes cutoff, the brain has to wake itself to signal the respiratory system to kick back into gear. This often leads to breathing resuming with loud gasps, snorts, or body jerks that may wake you from your slumber and disrupt your sleep. When you are awaken multiple times through the night, your body and mind don’t get the rest they need to function, leaving you tired and drained during the daytime. How is sleep apnea related to heart disease? During an apnea event (pause in breathing) the oxygen levels in your blood drop significantly. When this happens your brain partially wakes from sleep to send signals to the nervous system to constrict the blood vessels (tighten up) in order to increase the flow of oxygen to your heart and brain. When your blood pressure increases at night to keep oxygen flowing to your heart and brain, it causes high blood pressure during sleep. Most people’s blood pressure drops ten to twenty percent during sleep, but many patients with sleep apnea show an increase in blood pressure of ten to twenty percent.
blood pressure only needs to be increased at night when you require extra respiratory effort to get oxygen, many people with sleep apnea end up with increased blood pressure at all times. High blood pressure is a major risk factor for heart disease, stroke, heart attack, and many other medical problems, and sleep apnea is a major risk for high blood pressure. Over 25 million Americans are affected by this condition of that number, 80 percent are unaware that they even have this disease. OSA can cause and worsen a host of other medical conditions, including diabetes, dementia. However, untreated OSA has the greatest impact on your heart and cardiovascular system. Here are some facts on OSA and heart disease are linked: ► 50% of people with OSA have high blood pressure. ► If untreated, OSA is 4x more likely to stop your blood pressure medications from working. ► You are 4 x more likely to develop atrial fibrillation (a leading cause of stroke). ► 70% of patients admitted to the hospital with coronary artery disease (hardening of the arteries) have OSA. ► Tachycardia (fast beating heart) is 3x more likely. ► There is a 58% increase in congestive heart failure. ► Women are more likely to develop heart disease (and develop it faster than men). As with most diseases, early detection is key. All of us including our children should be screened, tested, and treated for OSA early, before severe complications arise. OSA Treatment has been shown to improve other health conditions, reduce excessive daytime sleepiness, and enhance patients’ overall quality of life. Once a medical doctor confirms a diagnosis of OSA, you can talk about the treatment option that works best for you. CPAP, surgery, and weight loss are all potential options — but those can be costly, cumbersome, and sometimes financially prohibitive. One of the easiest treatment methods is using a simple set of retainers made for you by your dentist. I can’t tell you how many OSA patients I’ve helped with this tiny appliance! Take some time this February to show your heart some love. It may save your life. Dr. Andrew Swiatowicz is the owner of Delaware Dental Sleep Medicine. He has been treating patients with obstructive sleep apnea since he was in dental school. Dr. Swiatowicz is the only AADSM qualified dentist in the state of Delaware.
Unfortunately, the increased blood pressure experienced during sleep often begins to overlap into periods of wakefulness. Even though your www.livingwellmagazine.net
February 2019
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