Salud & Nutrición

DOES THE HEART NEED SLEEP?

Obe­si­ty Con­tributes to Sleep Ap­nea

One in five adults suf­fers from at least mild sleep ap­nea and it af­flicts more men than women, Dr Ar­nett said. The most com­mon type is ob­struc­tive sleep ap­nea in which weight on the up­per chest and neck con­tributes to block­ing the flow of air.

Ob­struc­tive sleep ap­nea (OSA) is as­so­ci­at­ed with obe­si­ty, which is al­so a ma­jor risk fac­tor for di­a­betes, 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, Dr Ar­nett ex­plained. 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

Health Plus Med­ical Cor­re­spon­dent

Through all this un­cer­tain­ty of the COVID-19 pan­dem­ic, one thing for cer­tain is that sleep is ex­treme­ly im­por­tant to the heart as much as it is to the mind and vi­tal or­gans. If you are one of the many peo­ple who toss and turn night­ly, you are no stranger to how a sleep­less night can af­fect your mo­ti­va­tion, at­ti­tude and pro­duc­tiv­i­ty of your day. How­ev­er, the ram­i­fi­ca­tions of poor sleep ex­tend far be­yond a cranky mood.

Plain old snor­ing can get a lit­tle an­noy­ing, es­pe­cial­ly for some­one lis­ten­ing to it. But when a snor­er re­peat­ed­ly stops breath­ing for brief mo­ments, it can lead to car­dio­vas­cu­lar prob­lems and po­ten­tial­ly be life-threat­en­ing.

It is a con­di­tion known as sleep ap­nea, in which the per­son may ex­pe­ri­ence paus­es in breath­ing five to 30 times per hour or more dur­ing sleep. These episodes wake the sleep­er as he or she gasps for air. It pre­vents rest­ful sleep and is as­so­ci­at­ed with high blood pres­sure, ar­rhyth­mia, stroke and heart fail­ure.

Ob­struc­tive sleep ap­nea (oxy­gen de­pri­va­tion dur­ing sleep) in­creas­es the risk of heart fail­ure by 140%, the risk of stroke by 60%, and the risk of coro­nary heart dis­ease by 30% ac­cord­ing to re­search from Mayo Clin­ic.

The ev­i­dence is very strong for the re­la­tion­ship be­tween sleep ap­nea and hy­per­ten­sion and car­dio­vas­cu­lar dis­ease gen­er­al­ly, so peo­ple re­al­ly need to know that,” said Don­na Ar­nett, Ph.D., chair and pro­fes­sor of epi­demi­ol­o­gy at the School of Pub­lic Health at Birm­ing­ham and the in­com­ing pres­i­dent of the Amer­i­can Heart As­so­ci­a­tion.

Obe­si­ty Con­tributes to Sleep Ap­nea

One in five adults suf­fers from at least mild sleep ap­nea and it af­flicts more men than women, Dr Ar­nett said. The most com­mon type is ob­struc­tive sleep ap­nea in which weight on the up­per chest and neck con­tributes to block­ing the flow of air.

Ob­struc­tive sleep ap­nea (OSA) is as­so­ci­at­ed with obe­si­ty, which is al­so a ma­jor risk fac­tor for di­a­betes, 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, Dr Ar­nett ex­plained. 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.

Lis­ten to Those Snor­ing Com­plaints

Of­ten a sleep­ing part­ner or room­mate of some­one with sleep ap­nea no­tices it. “It’s re­al­ly hard to de­tect if you live alone, un­less you go through a sleep study,” Dr Ar­nett said. Peo­ple with sleep ap­nea may be more tired dur­ing the day, she said, and there­fore prone to ac­ci­dents or falling asleep.

Get­ting enough sleep is of­ten a chal­lenge as we try to man­age and jug­gle the re­spon­si­bil­i­ties of life, work, home and school et cetera but the qual­i­ty of our sleep is even more detri­men­tal to our health than the length of time we sleep. Sleep de­prived suf­fer­ers typ­i­cal­ly look at the amount of sleep ob­tained from night to night as a gauge to mea­sure their sleep health but fail to un­der­stand that the qual­i­ty of sleep is far more im­por­tant in the long run. The heart, lungs and brain are work­ing less ef­fi­cient­ly while asleep in un­treat­ed Sleep Ap­nea.

The re­la­tion­ship be­tween sleep and heart fail­ure is a two-way street.

Sud­den drops in blood oxy­gen lev­els that oc­cur dur­ing sleep in­crease blood pres­sure and put strain on the car­dio­vas­cu­lar sys­tem. A ha­bit­u­al snor­er is at risk of Ob­struc­tive Sleep Ap­nea (OSA) and in­creas­es their risk of high blood pres­sure (hy­per­ten­sion) and al­so the risk of re­cur­rent heart at­tack, stroke and ab­nor­mal heart­beats, atri­al fib­ril­la­tion and car­diac ar­rhyth­mias. If you have heart dis­ease, mul­ti­ple episodes of low blood oxy­gen (hy­pox­ia or hy­pox­emia) can lead to sud­den death lead­ing to an ir­reg­u­lar heart­beat and sys­temic com­pli­ca­tions.

Get­ting Prop­er Treat­ment

In a sleep study, doc­tors count paus­es in breath­ing to de­ter­mine whether the pa­tient has mild sleep ap­nea, char­ac­terised by five to 15 episodes per hour; mod­er­ate sleep ap­nea, de­fined by 15 to 30 per hour; or se­vere sleep ap­nea, mean­ing more than 30 each hour. It’s cer­tain­ly pos­si­ble to have sim­ple, loud snor­ing with­out sleep ap­nea. But with reg­u­lar snor­ing, the per­son con­tin­ues to in­hale and ex­hale.

With sleep ap­nea, the sleep­ing per­son tends to have pe­ri­ods when he or she stops breath­ing and noth­ing can be heard. The good news is treat­ment that keeps the breath­ing pas­sages open and oxy­gen flow­ing can yield fast re­sults, Dr Ar­nett said. “Blood pres­sure comes down re­al­ly quite quick­ly.”

Through treat­ment known as con­tin­u­ous pos­i­tive air­way pres­sure, or CPAP, the pa­tient’s blood pres­sure sta­bi­lized. The CPAP de­vice in­volves wear­ing a mask while sleep­ing. It keeps air pres­sure in the breath­ing pas­sages so they don’t close down.

Tips for a Good night’s Heart Healthy Sleep Regime

Once a thor­ough as­sess­ment is made and treat­ment en­sues, it is al­so im­por­tant to cre­ate a Heart healthy Sleep Regime.

– Go to sleep at the same time each night, and get up at the same time each morn­ing, even on the week­ends.

– Do not take naps af­ter 3pm and do not nap longer than 20 min­utes.

Stay away from caf­feine and al­co­hol late in the day.

Avoid nico­tine com­plete­ly.

Get reg­u­lar ex­er­cise, but not with­in two to three hours of bed­time.

– Do not eat a heavy meal late in the day. A light snack be­fore bed­time is OK.

Make your bed­room com­fort­able, dark, qui­et, and not too warm or cold.

– Fol­low a rou­tine to help you re­lax be­fore sleep (for ex­am­ple, read­ing or lis­ten­ing to mu­sic). Turn off the TV and oth­er screens at least an hour be­fore bed­time.

– Do not lie in bed awake. If you can’t fall asleep af­ter 20 min­utes, do some­thing calm­ing un­til you feel sleepy, like read­ing or lis­ten­ing to soft mu­sic.

Talk with a doc­tor if you con­tin­ue to have trou­ble sleep­ing.

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