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Excessive snoring isn’t just frustrating, it sometimes signals a more serious sleep condition called sleep apnea. If you’ve ever woken yourself or your partner up with a sudden, disruptive snore, it’s possible you could have sleep apnea, a sleep disorder that is associated with high blood pressure, arrhythmia, stroke and heart failure.

As a cardiac electrophysiologist at Tallahassee Memorial HealthCare (TMH), I’ve seen all these symptoms in patients due to sleep apnea. Those explosive snorts and paused breathing in the middle of the night aren’t just scary to your partner, they could be hurting your heart.

What is Sleep Apnea?

Sleep apnea is a sleep disorder in which a person’s breathing repeatedly stops while sleeping. Regular snoring is a sound that occurs when air passes relaxed tissues in your throat as you sleep. It’s important to note, not everyone who snores has sleep apnea.

There are different types of sleep apnea:

  • Obstructive sleep apnea (OSA) is the most common type that occurs when throat muscles relax and block the flow of air into the lungs.
  • Central sleep apnea (CSA) happens when your brain doesn’t communicate proper signals to the muscles that control breathing.
  • Complex sleep apnea is a combination of the two.

How Sleep Apnea Impacts Your Heart

OSA prevalence is as high as 40 to 80% in patients with hypertension, heart failure, coronary artery disease, pulmonary hypertension, atrial fibrillation and stroke.

For people with OSA, it becomes hard to keep the upper airway open during sleep because weight overpowers the muscles that hold it open. Every time the airway closes during sleep, there is a pause in breathing that can occur five to 30 times an hour or more. When the air flow ceases, a stress hormone releases in the body which can lead to heart disease over time.

Tossing and turning in the middle of the night from sleep apnea can cause you to regularly miss sleep, which can also negatively affect your heart. Sleep plays an important role in cardiovascular health, allowing the body to rest and recuperate.

During sleep, your heart rate and blood pressure drop as breathing becomes regular and stable. A lack of sleep means your heart and cardiovascular system aren’t getting important recovery time. This can also increase your risk for type 2 diabetes, liver problems and metabolic syndrome.

Sleep Apnea and AFib

The Heart Rhythm Society reports that people with sleep apnea are about four times as likely to develop a heart rhythm disorder called atrial fibrillation, or AFib, and about half of people with AFib also have sleep apnea.

The most common heart rhythm disorder, AFib is an irregular, often rapid, heart rate that leads to poor blood flow and sometimes stroke.

While our understanding of the connection between sleep apnea and AFib is evolving, we do know that untreated sleep apnea can lead to AFib. This may be due to a couple factors.

Some of the conditions that untreated sleep apnea increases your risk for – specifically diabetes and hypertension – in turn increase your risk for atrial fibrillation.

If you have sleep apnea, you’re familiar with the sudden feeling of not having enough oxygen that startles you awake. Each time this happens, stress is put on your heart, sometimes triggering arrythmias, or periods of irregular heart beats.

Studies have also shown that sleep apnea can reduce the efficacy of some AFib treatments, making it more difficult to manage the heart rhythm disorder. According to the Heart Rhythm Society, new research suggests that, in patients who have both AFib and sleep apnea, treating both is key to better overall health.

Common Symptoms

Though there are different types of sleep apnea, the symptoms of obstructive and central sleep apnea overlap. Some of the most common symptoms of both are:

  • Loud snoring
  • Gasping for air during sleep
  • Episodes of paused breathing while sleeping
  • Morning headache
  • Dry mouth when waking up
  • Insomnia
  • Daytime fatigue
  • Irritability
  • Difficulty paying attention while awake

Risk Factors for Sleep Apnea

Certain factors, such as age, preexisting conditions and lifestyle habits, may increase your risk for developing sleep apnea.

For obstructive sleep apnea, risk factors include:

  • Excess weight
  • A narrowed airway
  • Being male
  • Being older
  • Family history
  • Excessive use of alcohol or sedatives
  • Smoking
  • Nasal congestion or allergies

For central sleep apnea, risk factors include:

  • Being older
  • Heart disorders
  • Being male
  • Use of narcotic pain medicine
  • Stroke

How to Treat Sleep Apnea

Though sleep apnea is a common sleep disorder, many people don’t seek treatment or professional help, which could be fatal. Many of the conditions untreated sleep apnea can lead to pose their own potentially life-threatening risks. Heart disease is the number one killer in the Unites States, and AFib can lead to deadly strokes. So, keeping your sleep apnea under control is key.

Treatment can look different for everyone, but four forms of treatment include:

  • Weight loss
  • Adopting healthy sleep habits
  • Avoiding alcohol or certain medications
  • Using a breathing device at night, such as a CPAP machine

If you have a moderate case of sleep apnea, your doctor may recommend devices, treatments or surgery to help open your airway. A common form of therapy includes using a continuous positive airway pressure (CPAP) machine. CPAP machines use a mask to deliver constant air pressure into your nose or mouth to help keep your throat open.

If you’re struggling to get a good night’s sleep and you have a mild case of sleep apnea, your doctor may recommend lifestyle changes including:

  • Getting regular physical activity (but not right before bed)
  • Avoiding caffeine before bed
  • Incorporating a pre-bedtime routine like taking a warm bath, dimming the lights or having herbal tea

If sleep apnea goes untreated and undiagnosed it will only get worse with more frequent or longer apneic episodes.

When to See a Doctor

Loud snoring can indicate a potentially serious problem, but not everyone who has sleep apnea snores.

The good news is most sleep conditions are treatable. Talk to your healthcare provider if you have sleep apnea symptoms or if you have sleep problems that leave you fatigued, sleepy and irritable.

Your primary care doctor may advise you to see a sleep medicine specialist. Our Sleep Center team at TMH works with patients to identify symptoms and administer diagnostic tests to get to the root of your problem.

If your sleep apnea is caused by a heart condition or progresses to one, you should see a cardiologist. At Tallahassee Memorial, our skilled team of cardiovascular doctors is experienced in treating patients with sleep apnea and can help minimize impacts to your heart.

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Venkata Bavikati, MD

Cardiac Electrophysiologist at Tallahassee Memorial HealthCare