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While sleep is widely recognised as a period of rest and recovery, for many people, it often means that they suffer from sleep-disordered breathing that insidiously harms their heart health. Sleep apnea, most commonly Obstructive Sleep Apnea (OSA) is one of the most prevalent but under-recognised disorders of sleep with significant implications for cardiovascular health. In a conversation with The Daily Jagran, Dr Sushrut Ganpule, Consultant - Chest Medicine, Jupiter Hospital, Pune explained the direct impact of sleep disorders on the heart.

Sleep Apnea And Heart Disease

From a perspective of cardiology, the relationship between sleep apnea and heart disease is not merely coincidental; it is decidedly physiological. Each time someone with sleep apnea experiences a cessation of breathing during sleep, oxygen saturation decreases in their blood. This is called intermittent hypoxia and it places the body under stress. This intermittent hypoxia is accompanied by increased sympathetic nervous system activity or a "fight or flight" response, resulting in elevated blood pressure and stress to the heart. The health effects of repeated occurrences of sleep-disordered breathing, or obstructive apnea, over time manifest as sustained hypertension, which is one of the more robust risk factors for cardiovascular disease.

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In addition, the mechanical work of attempting to breathe through an occluded airway increases intrathoracic pressure. This increased work complicates normal cardiac function and may cause an increase in the size of the heart's chambers. This can lead to higher rates of arrhythmia, including atrial fibrillation and heart failure, in people with untreated sleep apnea. Studies also indicate a direct relationship between sleep apnea and coronary artery disease. The constant catecholamine stress reaction leads to inflammation and oxidative stress which fast-tracks the deposition of fatty substances into blood vessels, which ultimately can lead to a heart attack.

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The connection is reciprocity. Sleep apnea not only complicates heart disease but conditions related to the cardiovascular system can also exacerbate sleep-disordered breathing. For example, fluid accumulation in heart failure patients can move positions during the night and narrow the airway, worsening the episodes of apnea. This interdependence is why sleep evaluation has become a major interest for cardiologists--as they recognise it to be a key part of a complete evaluation of the heart.