Sleep Apnea Worsens Heart Disease – Yet It Often Goes Untreated

Assertion Highlights:

Well being care specialists urge elevated consciousness of obstructive sleep apnea amongst individuals with heart problems or threat components similar to hypertension, based on a brand new scientific assertion from the American Heart Affiliation, printed right this moment in Circulation, the Affiliation’s flagship journal.

Obstructive sleep apnea (OSA) happens in 40% to 80% of individuals with heart problems, but it’s under-recognized and undertreated, based on the assertion. OSA happens when an higher airway obstruction causes repeated episodes of disrupted respiratory throughout sleep. Signs embody loud night breathing, lapses in respiratory, fragmented sleep and daytime sleepiness. Generally, about 34% of middle-aged males and 17% of middle-aged girls meet the factors for OSA.

“Obstructive sleep apnea can negatively affect sufferers’ well being and enhance the danger of cardiovascular occasions and loss of life. This assertion is to encourage elevated consciousness, screening and remedy as applicable for sleep apnea,” stated Chair of the scientific assertion writing group Yerem Yeghiazarians, M.D., FAHA, professor of drugs and the Leone-Perkins Household Endowed Chair in Cardiology on the College of California, San Francisco. 

Danger components for OSA embody weight problems, giant neck circumference, craniofacial abnormalities, smoking, household historical past and nighttime nasal congestion. OSA is related to a number of cardiovascular problems, as detailed in Determine 2 of the assertion:

Whereas there’s no consensus that screening for OSA alters medical outcomes, the excessive prevalence of OSA amongst individuals with heart problems, together with proof that OSA remedy improves affected person high quality of life, are causes to display and supply remedy, based on the assertion writing group.

“Sufferers report higher temper, much less loud night breathing, much less daytime sleepiness, improved high quality of life  and work productiveness with OSA remedy,” Yeghiazarians stated. “As well as, screening advances have modified how we diagnose and deal with obstructive sleep apnea. For instance, many sufferers don’t have to go to an in a single day sleep examine middle anymore. There are actually sleep units authorised by the FDA that sufferers use at residence and ship again to their physician for evaluation. And, whereas a steady optimistic airway strain (CPAP) machine is one type of remedy, there are quite a few therapeutic choices – from positional remedy and weight reduction to oral home equipment and surgical procedure – relying on the trigger and severity of somebody’s OSA.”

The authors recommend:

“Enhancements in residence diagnostic instruments and extra analysis on methods to determine cardiovascular threat in individuals with OSA are wanted,” Yeghiazarians stated. “Nonetheless, the general message is obvious: we have to enhance consciousness about screening for and treating OSA, particularly in sufferers with present cardiovascular threat components.”

Reference: “Obstructive Sleep Apnea and Cardiovascular Disease: A Scientific Assertion From the American Heart Affiliation” by Yerem Yeghiazarians, Hani Jneid, Jeremy R. Tietjens, Susan Redline, Devin L. Brown, Nabil El-Sherif, Reena Mehra, Biykem Bozkurt, Chiadi Ericson Ndumele, Virend Ok. Somers, and on behalf of the American Heart Affiliation Council on Medical Cardiology; Council on Peripheral Vascular Disease; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiopulmonary, Vital Care, Perioperative and Resuscitation; Stroke Council; and Council on Cardiovascular Surgical procedure and Anesthesia, 21 June 2021, Circulation.

This scientific assertion was ready by the volunteer writing group on behalf of the American Heart Affiliation’s Council on Medical Cardiology; the Council on Peripheral Vascular Disease; the Council on Arteriosclerosis, Thrombosis and Vascular Biology; the Council on Cardiopulmonary, Vital Care, Perioperative and Resuscitation; the Stroke Council; and the Council on Cardiovascular Surgical procedure and Anesthesia. 

Co-authors and members of the volunteer writing group are Vice Chair Hani Jneid, M.D., FAHA; Jeremy R. Tietjens, M.D.; Susan Redline, M.D.; Devin L. Brown, M.D., M.S., FAHA; Nabil El-Sherif, M.D.; Reena Mehra, M.D.; Biykem Bozkurt, M.D., Ph.D., FAHA; Chiadi Ericson Ndumele, M.D., Ph.D., FAHA; and Virend Ok. Somers, M.D., Ph.D., FAHA. Writer disclosures are within the manuscript.

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