Sleep apnea can cause dangerous conditions

At age 37, Jeff Stone, a machinist by trade, went to the doctor to discuss his snoring problem. He was gaining weight, felt fatigued and was falling asleep during the day. On numerous occasions, Stone’s wife had seen him stop breathing and gasp for air while he slept. His doctor’s evaluation suggested that he had a disorder called obstructive sleep apnea. Worse yet, there were signs that it was damaging his heart.

“They did a chest X-ray, which showed that my heart was enlarged,” Stone said. “A little while later, I had what’s called an echocardiogram, which is an ultrasound of the heart. And they discovered some problems there: pulmonary hypertension and pooling of blood in the last chamber of the heart.”

Besides high blood pressure in the lungs, called pulmonary hypertension, he was battling high blood pressure in the rest of his body. His pressures had gotten progressively worse over the past six to eight months despite treatment from several doctors.

“I got to the point I had tunnel vision and everything else, and was on the verge of a stroke,” Stone said.

Apnea bad for heart

The effects of obstructive sleep apnea are caused by excess soft tissues at the back of the throat and palate. The tissues collapse during the more relaxed state during sleep, and the resulting blockage keeps much needed air from getting into the lungs. Characteristic symptoms include loud snoring and apneic spells, in which the person stops breathing for 10 seconds to a minute, often hundreds of times during the night.

The resulting oxygen deficiency can lead to a variety of other problems in the 18 million people in this country, about one-fifth of the adult population, who suffer from sleep apnea. These include daytime drowsiness, morning headaches, irritability, poor concentration and memory problems. There’s also an increased likelihood of heart disease and strokes.

“If your spouse in lying next to you and snoring, that puts them at much higher risk for cardiovascular disease,” said Dr. Lee Goldberg, a cardiologist and director of the Heart Failure Disease Management Program at University of Pennsylvania School of Medicine.

Cardiovascular effects

Goldberg gave me several research papers that link obstructive sleep apnea with the following types of heart and blood vessel problems:

Coronary artery disease: The studies found that apnea is an independent risk factor for heart attacks and heart disease.

Congestive heart failure: About a third of patients with heart failure have apnea.

Heart arrhythmias: A study found that 58 percent of sleeping apnea patients have irregular heartbeats, including some types linked to sudden cardiac death.

High blood pressure: About 40 percent of apnea patients have hypertension. And some 80 percent of patients with uncontrolled hypertension have apnea.

Stroke: The studies demonstrated a markedly increased risk for stroke in patients with apnea. An increased tendency toward blood vessel inflammation and blood clot formation in some apnea patients heightens this risk even further.

Turning it around

Getting treatment for obstructive sleep apnea can decrease your risk for heart attack and stroke, Goldberg said.

That’s exactly what Stone did. Besides dieting and exercising, he started sleeping with a continuous positive airflow pressure machine to keep his throat open.

Today, he’s much healthier for it. His blood pressures are down, his heart is not enlarging anymore, and he feels better. “It’s made a big difference in my life,” Stone said.

Contact Dr. Elizabeth Smoots, a board-certified family physician and fellow of the American Academy of Family Physicians, at doctor@practicalprevention.com. Her columns are not intended as a substitute for medical advice or treatment. Before adhering to any recommendations in this column consult your health care provider.

2006 Elizabeth S. Smoots.