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.