Sleep Apnea and Heart Disease

Man in his forties (40s) snoring in bed with type 2 diabetes and OSA.

Sleep Apnea and Type 2 Diabetes Prove a Deadly Combination

Man in his forties (40s) snoring in bed with type 2 diabetes and OSA.

Blindness is a big risk for those with type 2 diabetes and OSA.

Of the 29 million adults with diabetes, 90 to 95 percent of all diagnosed cases have type 2 diabetes, according to the CDC. Another large percentage of adults with this disease also have obstructive sleep apnea (OSA), which may or may not be the cause of type 2 diabetes. OSA is a condition that makes it hard to sleep, causing snoring and interrupted breathing during the night. These symptoms occur when you have a blockage in your throat during sleep, due to a large neck or small airways. Overall, OSA makes it difficult to breathe at night.

Researchers continue to look for the link between type 2 diabetes and OSA through several studies. The most recent study looking into the connection between the two reveals a startling discovery. Left untreated, people with both type 2 diabetes and OSA are at greater risk. These patients can develop a condition that causes blindness.

Diabetic Retinopathy

Around 40 to 50 percent of patients with diabetes have diabetic retinopathy, the most common form of diabetic eye disease. In fact, this condition is the leading cause of blindness in the western world. High blood sugar levels can cause damage to the blood vessels in your retina. When this occurs, the blood vessels will either:

  • Swell and leak
  • Close, stopping blood flow
  • Or grow abnormal blood vessels

You can find out more from the American Academy of Ophthalmology by clicking here.

How the Condition Develops With Type 2 Diabetes and Sleep Apnea

The study at the University of Birmingham is the first to look at the impact of OSA on diabetic retinopathy. It also leads towards the theory that OSA can cause or worsen your diabetes. The researchers tested 230 patients with Type 2 diabetes, accessing them for both OSA and diabetic retinopathy.

“Firstly, we showed that sight-threatening diabetic retinopathy was more common in patients with both Type 2 diabetes and OSA compared to those with Type 2 diabetes but without OSA,” states Doctor Abd Tahrani. Dr. Tahrani is the corresponding author of the University of Birmingham’s Institute of Metabolism and System Research.

“However, more importantly, we have shown that patients with OSA and Type 2 diabetes, compared to those with diabetes only, are at increased risk of developing advanced diabetic retinopathy over a period of three years and seven months.”

Researchers found that the prevalence of diabetic retinopathy was 42.9 percent in those with OSA. This is higher than the prevalence in those with just type 2 diabetes. Meanwhile, after reviewing the patients 43 months later, the researchers discovered that those with OSA were 18.4 percent more likely to develop a moderate to severe case of the disease.

“Our findings are important because improved understanding of the pathogenesis of diabetic retinopathy is important in order to identify new treatments,” states Dr. Tahrani.

“Following our research, it is important that clinicians treating patients with Type 2 diabetes are aware that their patients who also have OSA are particularly at increased risk of developing advance retinopathy and, hence, appropriate preventative measures should be put in place.

A hospital doctor taking notes as paramedics arrive with patient with a heart condition.

How Sleep Deprivation Puts Your Heart at Risk

A hospital doctor taking notes as paramedics arrive with patient with a heart condition.

Both doctors and paramedics run the risk of heart disease as they work 24-hour shifts.

Suppose you put in an all-nighter at work. From your perspective, sacrificing a couple of hours of sleep is no big deal. You might feel a little sluggish in the morning, but it’s nothing that a cup of coffee can’t fix, right? Unfortunately, that’s where you are wrong. Sleep deprivation does more than just make you tired. Receiving too little sleep can have a negative long-term effect on the body, especially the heart.

The Toll of Working Long Hours

It’s no secret that people in the United States often work too much, but some jobs require that they do so. The Radiological Society of North America (RSNA) noticed that a lot of high-stress jobs were taking a toll on workers. These jobs include fire and emergency medical services, as well as medical residencies and more. Often, they have to go above and beyond to fulfill their services, and that requires working up to 24-hour shifts. Doing work like this frequently has some an impact on how the body functions and the RSNA wanted to find out exactly how.

Sleep and the Heart

In a study that included 20 radiologists (19 men and one woman), researcher tested their cardiac function before and after a 24-hour shift. They were able to do this by using a cardiovascular magnetic resonance (CMR) imaging with strain analysis. As predicted, strain, blood pressure, and heart rate increased significantly.

Study author Daniel Kuetting, M.D., from the department of diagnostic and Interventional Radiology at the University of Bonn in Bonn, Germany had this to say: “For the first time, we have shown that short-term sleep deprivation in the context of 24-hour shifts can lead to a significant increase in cardiac contractility, blood pressure, and heart rate.”

While this study needs a larger test base, it shows that further research is warranted. It is also a warning for workers in high-stress positions. The toll sleep deprivation takes on your heart can lead to further complication and if you want to remain healthy for a long time, it may be time to reconsider sleeping less than 3 hours a night.

A male doctor is checking blood pressure of a young woman at a medical office, in order to find out if see has hypertension.

Sleep Apnea-Related Hypertension

A male doctor is checking blood pressure of a young woman at a medical office, in order to find out if she has hypertension.

Hypertension is just one of the many conditions that can arise due to sleep apnea.

Untreated obstructed sleep apnea (OSA) is known to lead to other disorders. One condition it contributes to is hypertension. Hypertension, which is better known as high blood pressure, is a medical condition where the blood pressure in the arteries is elevated. According to a new study performed by scientists at the University of Chicago, there may be a way to manage this condition in those with sleep apnea.

How Does Hypertension Affect the Body?

Hypertension is a troubling condition. According to the CDC, 1 of 3 U.S. adults (70 million people) have high blood pressure. It is also the second leading cause of death in America — because it can lead to heart disease and stroke.

Patients with hypertension will often display the following symptoms:

  • Headaches
  • Lightheadedness
  • Vertigo
  • Tinnitus
  • Altered vision

Some lifestyle choices and health conditions, like sleep apnea, may cause high blood pressure. Unfortunately, the condition can also be a part of one’s family history. This makes it harder to lower or control risk factors.

Sleep Apnea-Related Hypertension

OSA is a common cause of high blood pressure. Scientists have found that a signaling cascade associated with sleep apnea is the cause of this condition. This means that when your body doesn’t get enough blood-oxygen, the carotid bodies send signals to increase breathing and return oxygen to normal. However, blood pressure increases along with oxygen.

By nailing down which signals lead to high blood pressure, the scientists were able to offer a solution. Researchers suggest using a drug to disrupt the enzyme, known as cystathionine-y-lyase, which sends the signal (hydrogen sulfide) to increase oxygen and blood pressure.

According to the authors of the study, “Our results … suggest that inhibiting cystathionine-y-lyase to reduce hydrogen sulfide signaling in the carotid body with more potent inhibitors than L-PAG may be a novel approach to treat hypertension in patients with sleep apnea.”

A doctor is using a stethoscope to listent to a patient's heart. This is a common procedure for heart patients.

Sleep Disorders Leave Heart Patients at Risk

A doctor is using a stethoscope to listen to a patient's heart. This is a common procedure for heart patients.

Despite surgery, heart patients are still at risk for complications if they suffer from a sleep disorder.

Sleep disorders, like sleep apnea, can have a negative impact on your health. Prolonged suffering has been known to cause diabetes and cognitive deficiencies, as well as affect your overall quality of life. New research suggests that heart patients who have some form of sleeping disorder are at risk of developing further complication—and even death.

The Risk to Heart Patients

All 241 of the patients who participated in the study successfully underwent a procedure called percutaneous coronary intervention (PCI). The procedure is meant to treat acute coronary syndrome (ACS), a condition where the blood supplied to the heart is blocked. PCI seeks to remove the blockage and reopen blocked arteries.

The goal of the study was to gather more data on the link between sleep apnea and heart disease. “Sleep-disordered breathing, which includes snoring and sleep apnea, has long been recognized as an important risk factor for heart disease. However, there is limited awareness of sleep-disordered breathing among cardiologists who care for PCI patients,” said Toru Mazaki, M.D., study author and chief physician of the Department of Cardiology, Kobe Central Hospital, Kobe, Japan.

When the patients were hospitalized for the surgical procedure, researchers examined their breathing during the night. For the next 5.6 years, the patients’ health was monitored for any further complications. Here is what they found:

  • 3 percent had sleep-disordered breathing.
  • 4 percent of those with sleep-disordered breathing had major cardiovascular events.
  • Only 7.8 percent of those without sleep-disordered breathing had major cardiovascular events.

These cardiovascular events include deaths, strokes, recurrent ACS, and heart failure. The research shows that there may be a link between the two disorders, even after the person has taken care of their heart issue.

Sleep disorders are becoming a prevalent problem for many people. The researchers hope that other doctors see sleep disorder as a warning signal for heart patients. “Doctors and patients should consider sleep studies post-PCI to rule out sleep-disordered breathing or take necessary precautions to restore healthy breathing during sleep,” says Dr. Mazaki.

The doctors even suggest that hospitalized heart patients who have undergone surgery should be routinely tested for sleep-disordered breathing. More research still needs to be done, and hopefully doctors can treat patients before their sleep disorder leads to more complications.

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