The Link Between Heart Health and Good Sleep

September 02, 2020

Sleep and heart health are closely related. Those who do not get sufficient sleep or do not get quality sleep are more likely to have cardiovascular problems. In fact, general poor sleep quality is associated with abnormal blood pressure patterns in sleep, research shows.

One of the causes of poor sleep quality is obstructive sleep apnea. Obstructive sleep apnea is a common sleep disturbance involving obstructive breathing during sleep. These breathing pauses cause oxygen to be reduced to the body and arousals to wake up and resume breathing. The disruptive breathing causes increases in heart rate, blood pressure and fragmented, poor quality sleep. As a result, obstructive sleep apnea is a cause of high blood pressure and is associated with an increased incidence of stroke, heart failure, arrhythmia (atrial fibrillation), and coronary heart disease.

How Common is Sleep Apnea in People with Heart Conditions?

The rate of sleep apnea has increased in the United States. Estimated prevalence is about 3 to 9 percent of women and 10 to 17 percent of men, with higher prevalence in the older population up to 55 percent.

In certain populations with heart conditions, rates of sleep apnea are even higher. For example, those with heart failure have a 25 to 60 percent rate of a moderate degree of sleep apnea. The rate of sleep apnea in pulmonary hypertension is up to 89 percent and 23 to 68 percent in those with atrial fibrillation. There are many undiagnosed cases of sleep apnea, especially in females and those with lower weight who are less likely to be suspected for sleep apnea.

Risks of sleep apnea include age, genetic factors, race, craniofacial risks, obesity, males and women in menopause.

Sleep Apnea Symptoms

Symptoms of sleep apnea include:

Excessive daytime sleepiness/fatigue (less common in heart failure, which may contribute to its under-recognition)
Snoring
Irregular breathing during sleep, gasping for air
Waking up frequently during the night
Waking up to urinate
Poor mood or concentration during the day
Dry mouth upon awakening

How Sleep Apnea Is Treated

The treatment of sleep apnea can help control blood pressure and rate of arrhythmia. The most effective and first line therapy for all types of obstructive sleep apnea is continuous positive airway pressure (CPAP).

CPAP involves an interface that delivers just enough air pressure to re-open the airway during sleep, allowing improvement in sleep quality, breathing levels and oxygen.

There are other non-PAP treatments for sleep apnea for those who cannot tolerate the use of CPAP therapy. Consultation with sleep medicine specialists can provide discussion of different treatments for obstructive sleep apnea.