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Sleep Apnea And Its Hidden Dangers For Heart Health

Published 12:30 pm Friday, April 4, 2025

By Dr. Jaisingh Rajput, MD 

Sleep is essential for heart health, but millions of Americans unknowingly suffer from sleep apnea, a serious disorder that disrupts breathing during sleep. Obstructive Sleep Apnea (OSA) affects nearly 30 million adults, yet 80% remain undiagnosed. 

Left untreated, sleep apnea significantly increases the risk of heart disease, high blood pressure, stroke, and sudden cardiac death. Understanding the connection between sleep apnea and heart health can save lives. If you or a loved one experience loud snoring, gasping for air at night, or excessive daytime sleepiness, it's time to seek medical evaluation.

What Is Sleep Apnea?

Sleep apnea is a disorder in which breathing repeatedly stops and starts during sleep due to an obstruction in the airway or a failure of brain signals.

Types of Sleep Apnea

  • Obstructive Sleep Apnea (OSA): The most common type, where the throat muscles relax and block the airway.
  • Central Sleep Apnea (CSA): The brain fails to send signals to the breathing muscles.
  • Complex Sleep Apnea Syndrome: A combination of OSA and CSA.
  • Sleep Apnea and Heart Disease

    Sleep apnea is more than just a snoring problem — it puts immense stress on the cardiovascular system. Each time breathing stops, oxygen levels drop, triggering the body's "fight or flight" response. This leads to:

  • High Blood Pressure (Hypertension): OSA is a major cause of resistant hypertension (high blood pressure that doesn't respond to medication).
  • Heart Arrhythmias (Irregular Heartbeats): Sleep apnea increases the risk of atrial fibrillation (AFib) and other life-threatening arrhythmias.
  • Coronary Artery Disease (CAD): Repeated oxygen deprivation damages blood vessels, increasing the risk of heart attacks.
  • Heart Failure: Severe untreated OSA can lead to heart enlargement and failure.
  • Stroke: Sleep apnea doubles the risk of stroke, especially in middle-aged and older adults.
  • Recognizing the Symptoms

    Many people do not realize they have sleep apnea, as symptoms occur during sleep. Look out for loud snoring; gasping, choking or pauses in breathing during sleep; excessive daytime sleepiness (falling asleep while driving, at work, or during conversations); morning headaches; difficulty concentrating or memory problems; irritability, depression or mood swings; frequent nighttime urination or high blood pressure that is difficult to control.

    Who Is at Risk?

    You may be at higher risk for sleep apnea if you are overweight or obese (extra fat around the neck narrows the airway); have a large neck circumference (17 or more inches in men, 16 or more inches in women); have a family history of sleep apnea; are male (men are 2-3 times more likely to develop sleep apnea than women); are over 40 years old; have nasal congestion or anatomical abnormalities (deviated septum, enlarged tonsils) or use alcohol or sedatives, which relax airway muscles.

    Guidelines for Diagnosis, Treatment

    A sleep study is used for diagnosis.

  • Polysomnography (PSG): Conducted in a sleep lab, monitoring brain activity, breathing, oxygen levels, and heart rate.
  • Home Sleep Apnea Test (HSAT): A portable device that measures breathing and oxygen levels while sleeping at home.
  • The American Academy of Sleep Medicine (AASM) and American Heart Association (AHA) recommend lifestyle changes:

  • Weight loss: Losing just 10% of body weight can significantly improve symptoms.
  • Sleeping on your side: Reduces airway obstruction.
  • Avoiding alcohol and sedatives: These relax throat muscles, worsening apnea.
  • Quitting smoking: Smoking increases inflammation and fluid retention in the airway.
  • Continuous Positive Airway Pressure (CPAP) Therapy is prescribed for treatment.

  • CPAP is the gold standard for moderate-to-severe sleep apnea.
  • It delivers pressurized air through a mask, keeping the airway open.
  • CPAP reduces blood pressure, heart disease risk, and daytime fatigue.
  • Alternative treatments include oral appliances and surgery.

  • Oral Appliances: Custom-fitted mouthpieces reposition the jaw to keep the airway open.
  • Surgical Options: For severe cases, procedures like uvulopalatopharyngoplasty (UPPP) or hypoglossal nerve stimulation may be recommended.
  • Sleep apnea is a serious but treatable condition. If left untreated, it can silently damage the heart and increase the risk of heart attacks, strokes, and sudden death.

    If you suspect you or a loved one has sleep apnea, schedule a sleep evaluation immediately. Treating sleep apnea not only improves sleep but also protects the heart, brain and overall health.

    Dr. Jaisingh Rajput is a physician specializing in hospital medicine and public health. He is committed to raising awareness about environmental health issues and their impact on respiratory diseases.


    What To Know About Congestive Heart Failure

    Congestive heart failure (CHF) is when the heart does not pump blood around the body efficiently. This can cause symptoms such as lung congestion and swelling due to fluid retention.

    According to the Centers for Disease Control and Prevention (CDC), over 6 million adults in the United States live with heart failure.

    The body relies on the heart's pumping action to deliver nutrient and oxygen-rich blood to each of its cells. In congestive heart failure (CHF), the heart cannot pump blood effectively, and the cells do not receive adequate nourishment. As a result, the body cannot function properly.

    If the heart becomes weakened and cannot supply the cells with sufficient blood, it can lead to fatigue, breathlessness, and swelling due to fluid retention. Everyday activities that used to be easy may become challenging.

    Heart failure can lead to severe complications, such as heart attack and cardiac arrest.

    CHF can be systolic or diastolic, depending on whether it affects the heart's ability to contract or relax. This article focuses mainly on systolic CHF and its causes, symptoms, types, and treatment.

    Congestion in the lungs

    Fluid builds up in the lungs and causes shortness of breath, even when a person is resting, particularly when they are lying down. It can also cause a dry, hacking cough.

    Fluid retention

    Less blood reaches the kidneys, which can result in water retention and can cause swelling of the ankles, legs, and abdomen. It can also cause weight gain.

    Fatigue and dizziness

    A reduction in the amount of blood reaching the brain and other organs can cause weakness, dizziness, and confusion.

    Irregular and rapid heartbeats

    The heart may pump more quickly to counteract the lower volume of blood it pumps out with each contraction. It may also activate stress receptors in the body, increasing the release of stress hormones. Heart failure can increase the risk of arrhythmias that can cause these symptoms.

    Many other conditions can cause similar symptoms, so it is important to see a doctor. People with a CHF diagnosis should monitor their symptoms carefully and report any sudden changes to their doctor immediately.

    The stages of heart failure are:

  • Stage A: A person has not yet developed heart failure but has a higher risk due to one or more preexisting conditions, such as high blood pressure, coronary artery disease, or diabetes.
  • Stage B: A person has not developed heart failure or symptoms but has received a diagnosis of structural heart disease.
  • Stage C: A person has ongoing or past symptoms of heart failure and currently has structural heart disease that needs advanced treatment.
  • Stage D: A person has advanced heart failure that needs advanced treatment.
  • Any condition that damages the heart muscle can cause systolic heart failure. These conditions include:

  • Coronary artery disease: The coronary arteries supply the heart muscle with blood. If these become blocked or narrowed, the flow of blood diminishes, and the heart does not receive the blood supply it needs.
  • Heart attack: This involves damage to the heart muscle. It can result from a sudden blockage of the coronary arteries that causes scarring and reduces how effectively the heart can pump. The damage may also result from an increased demand for blood flow due to a fixed blockage.
  • Nonischemic cardiomyopathy: This disease involves weakness of the heart muscle caused by something other than a blockage in the coronary arteries. Possible causes include genetic conditions, drug side effects, and infections.
  • Conditions that overwork the heart: Examples include valve disease, high blood pressure, diabetes, kidney disease, sleep apnea, and heart irregularities present at birth.
  • Risk factors for CHF include:

  • diabetes
  • obesity
  • smoking
  • a high intake of alcohol
  • anemia
  • thyroid problems, including hyperthyroidism and hypothyroidism
  • lupus
  • myocarditis, which is inflammation of the heart muscle that usually occurs due to a virus and can lead to left sided heart failure
  • heart arrhythmias, or irregularities — a fast heartbeat can weaken the heart, and a slow heartbeat can reduce blood flow, causing heart failure
  • atrial fibrillation, an irregular and often rapid heartbeat
  • hemochromatosis, a condition in which iron accumulates in the tissues
  • amyloidosis, in which deposits of proteins accumulate in one or more organ systems
  • Damage to the heart's pumping action is not always reversible. Nevertheless, treatments can significantly improve a person's quality of life by keeping heart failure under control and helping to relieve many of its symptoms. Treatment can also prevent CHF from progressing.

    CHF treatments include medications and surgery.

    Medications for heart failure

    Many medications can treat the symptoms of CHF. They include:

    Controlling blood pressure and cholesterol are also important considerations for treating heart failure, and a doctor may prescribe separate medications for this.

    Surgery for heart failure

    Not everyone with heart failure responds to drug treatments. In some cases, a doctor may recommend surgery to address the underlying cause and help manage symptoms. Surgical procedures include:

  • Coronary artery bypass graft: Doctors commonly recommend this procedure when coronary artery disease is the cause of CHF.
  • Percutaneous coronary intervention (PCI): This nonsurgical procedure involves placing a stent in the heart to open up the blood vessels.
  • Pacemaker: A surgeon places a small device called a pacemaker under the skin in the chest to help correct an irregular heartbeat.
  • Cardiac ablation: In cardiac ablation, a doctor inserts a catheter into the arteries or veins to help correct a heart rhythm problem.
  • Heart valve surgery: This procedure repairs a defective valve that makes the heart pump inefficiently.
  • Implantable left ventricular assist device: For people with advanced heart failure who have not responded to other treatments, this can help the heart pump blood. Doctors may recommend this for people waiting for a transplant.
  • Heart transplant: If no other treatments or surgeries help, a heart transplant is an option. Medical teams only consider a transplant for a person who is healthy beyond the problem affecting their heart.
  • A doctor, who may be a cardiologist, will recommend lifestyle modifications alongside medical treatment to address the underlying cause of a person's heart failure. They include:

    In addition, people with heart failure should keep up to date with vaccinations, including the yearly flu shot.

    If a doctor suspects heart failure, they will recommend further tests, which may include:

  • Blood and urine tests: The aim is to check the person's blood count, as well as their liver, thyroid, and kidney function and any indications of "stretch" in the heart. The doctor may also want to check the blood for specific chemical markers of heart failure.
  • Chest X-ray: This shows whether the heart has become enlarged. It will also show whether there is fluid in the lungs.
  • An electrocardiogram records the electrical activity and rhythms of the heart and may also reveal damage from a heart attack.
  • An echocardiogram: This ultrasound scan shows the heart's pumping action. Cardiologists measure the proportion of blood that leaves the left ventricle, the main pumping chamber, with each heartbeat. This measurement is known as the ejection fraction.
  • The doctor may also do additional tests, such as:

  • A stress test: This is to see how the heart responds to stress and determine whether there is a lack of oxygen due to blockages in the coronary arteries. A person may use an exercise machine, such as a treadmill, or take medication that stresses the heart.
  • A cardiac MRI or CT scan: This measures the ejection fraction and examines the heart's arteries and valves. The results can help doctors determine whether the person has had a heart attack.
  • A PET scan: Doctors use this to examine the heart muscle and look for signs of rare causes of heart problems, such as sarcoidosis.
  • An angiogram: An angiogram is an X-ray of the blood vessels around the heart. A doctor injects dye into the coronary arteries to help detect coronary artery disease or narrowed arteries, which can cause heart failure.
  • CHF can be life threatening, but a person's outlook will depend on the type of heart failure, the cause, the stage of the disease, and how effective treatment is.

    When heart failure results from cardiomyopathy or coronary artery disease, a person typically has a less positive outlook than someone with heart failure in its earliest stage.

    Complications can also affect a person's life expectancy and quality of life. They include:

  • having another health condition, such as obesity or diabetes
  • a reduced ability to function in daily life
  • kidney and liver problems
  • complications relating to treatment, such as low blood pressure or kidney failure
  • mental health challenges due to chronic disease
  • What is the life expectancy of a person with CHF?

    This will depend on the type of CHF, the severity of the condition, and individual factors, such as overall health and age. Overall, around half of people with a diagnosis of heart failure are likely to live another 5 years or longer. For those with advanced heart failure, 10% to 20% will live 1 year or longer after diagnosis.

    This will depend on the type of CHF, the severity of the condition, and individual factors, such as overall health and age. Overall, around half of people with a diagnosis of heart failure are likely to live another 5 years or longer. For those with advanced heart failure, 10% to 20% will live 1 year or longer after diagnosis.

    Is congestive heart failure serious?

    Doctors consider CHF a serious condition, and it can be life threatening. However, this will depend on the stage and other factors. With treatment, many people continue to function and enjoy a good quality of life.

    Doctors consider CHF a serious condition, and it can be life threatening. However, this will depend on the stage and other factors. With treatment, many people continue to function and enjoy a good quality of life.

    What are the signs of congestive heart failure?

    A person with CHF may have:

  • coughing and wheezing due to fluid in the lungs
  • shortness of breath
  • swelling in the abdomen and lower body because of fluid retention
  • fatigue
  • a diagnosis of a heart problem
  • A person with CHF may have:

  • coughing and wheezing due to fluid in the lungs
  • shortness of breath
  • swelling in the abdomen and lower body because of fluid retention
  • fatigue
  • a diagnosis of a heart problem
  • CHF affects millions of people in the U.S. Doctors cannot always reverse the damage involved, but treatments can provide symptom relief and improve quality of life.

    Anyone who experiences symptoms of heart failure should see a doctor for a diagnosis.


    Sleep Apnea Mortality Statistics And The Importance Of Treatment

    While sleep apnea itself is not a common cause of death, it does increase complications in people with other serious medical conditions, such as heart disease.

    Between 1999 and 2019, sleep apnea was determined to be an underlying cause of death in 17,053 people in the United States.

    People with sleep apnea have difficulty breathing or stop breathing for short periods while sleeping. This treatable sleep disorder often goes undiagnosed.

    Researchers of a 2019 analysis estimate that nearly 1 billion adults 30 years and older have obstructive sleep apnea, the most common type. Sleep apnea is more common in men than in women. Children can also have sleep apnea.

    Complications of sleep apnea

    Without treatment, sleep apnea can lead to serious complications. It may lead to or worsen several life threatening conditions, including:

    There are three types of sleep apnea:

  • Central sleep apnea happens when your brain doesn't send the right signals to the muscles that control your breathing.
  • Obstructive sleep apnea happens when your airway narrows or becomes blocked. It's the most common type.
  • Complex sleep apnea is a combination of central sleep apnea and obstructive sleep apnea.
  • Sleep apnea causes hypoxia (low oxygen level in the body). When this happens, your body becomes stressed and reacts with a fight-or-flight response, which causes your heart to beat faster and your arteries to narrow.

    Heart and vascular effects include:

  • higher blood pressure
  • higher heart rate
  • higher blood volume
  • more inflammation and stress
  • These effects increase the risk of cardiovascular problems.

    It's well established that obstructive sleep apnea can raise your risk of stroke.

    In addition, a 2021 review cites older studies that show obstructive sleep apnea is believed to:

  • be responsible for 38,000 cardiovascular deaths each year
  • increase risk of heart failure by 140%
  • increase risk of stroke by 60%
  • increase risk of coronary heart disease by 30%
  • A 2019 article looking at the relationship between obstructive sleep apnea and sudden cardiac death suggests that a connection exists. Obstructive sleep apnea may increase the risk of sudden cardiac death, though researchers stopped short of stating the likelihood.

    A 2023 study found that adults with obstructive sleep apnea had 1.5 times the risk of developing type 2 diabetes compared with people without sleep apnea.

    The most common symptom of sleep apnea is snoring. It's typically associated with obstructive sleep apnea due to nasal passages being blocked or narrowed.

    Other symptoms of sleep apnea include:

  • pauses in breathing
  • snorting or gasping
  • dry mouth
  • sore throat or coughing
  • insomnia or difficulty staying asleep
  • the need to sleep with your head raised
  • headaches upon waking up
  • daytime fatigue and sleepiness
  • irritability and depression
  • mood changes
  • memory problems
  • If you share a bed with someone, they're most likely to notice symptoms like snoring or gasping for breath at night.

    Can you have sleep apnea without snoring?

    The most well-known symptom of obstructive sleep apnea is snoring when you sleep. However, not everyone who has sleep apnea snores.

    Similarly, snoring doesn't always mean you have sleep apnea.

    While you sleep, you must wear a CPAP mask that is connected by tubing to the running device. It uses air pressure to hold your airway open.

    In some cases, a doctor may recommend surgery to treat sleep apnea.

    Other treatments and remedies for sleep apnea include:

  • losing weight if you have overweight or obesity
  • quitting tobacco smoking (your doctor can create a cessation plan that's right for you)
  • avoiding alcohol
  • avoiding sleeping pills
  • avoiding sedatives and tranquilizers
  • getting regular physical activity
  • using a humidifier
  • using nasal decongestants
  • changing your sleeping position
  • You may not be aware that you have sleep apnea. Your partner or another family member may notice that you snore, snort, or stop breathing during sleep or that you wake up suddenly. Talk with a doctor if you think you might have sleep apnea.

    Tell the doctor if you wake up tired or with a headache or feel depressed. Watch for symptoms like daytime fatigue, drowsiness, or falling asleep in front of the TV or at other times. Even mild sleep apnea can disrupt your sleep and lead to symptoms.

    Sleep apnea is linked to several life threatening conditions. It may cause or worsen chronic illnesses like high blood pressure. Sleep apnea can lead to sudden cardiac death.

    If you have a history of stroke, heart disease, diabetes, or another chronic illness, ask your doctor to test you for sleep apnea. Treatment may include getting a diagnosis at a sleep clinic and wearing a CPAP mask at night.

    Treating your sleep apnea will improve your quality of life and may even help save your life.






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