Sleep Apnea (cont.)
What are obstructive sleep apnea symptoms?
Obstructive sleep apnea has many well-studied consequences. First, as you would expect, it
disrupts sleep. Patients with disrupted sleep cannot concentrate, think, or
remember as well during the day. This has been shown to cause more accidents in
the work place and while driving. Thus, people with obstructive sleep apnea have
a three-fold greater risk of a car accident than the general population.
Daytime sleepiness, fatigue, frequent naps,
headaches, irritability, insomnia, and poor memory and attention are some of the other common symptoms associated with sleep apnea as a result of insufficient sleep.
It is important to note that the bed partner of individuals with sleep apnea may also suffer from poor night time sleep and can have some of the same symptoms.
What are some of the complications of sleep apnea?
Obstructive sleep apnea (OSA) may be a risk factor for the development of other medical conditions. High blood pressure (hypertension), heart failure,
heart rhythm disturbances, atherosclerotic heart disease, pulmonary hypertension, insulin resistance, and even death are some of the known complications of untreated
obstructive sleep apnea.
High blood pressure
Sleep apnea causes high blood pressure and heart problems. Cessation of breathing frequently during the night (every 1-4 minutes) can cause increased stress on the heart. As the oxygen saturation in the blood decreases and the apnea continues, the sympathetic nervous system (responsible for the "fight or flight" response of the body) is activated. This fight or flight response sends nerve signals to the blood vessels to constrict (tighten up) and to the heart to work harder. When the vessels constrict, more blood is sent to the brain and muscles. However, this increases the blood pressure, which requires the heart to work harder to pump blood through the smaller caliber vessels. That, combined with the signal for the heart to work harder and the lower available oxygen in the blood from apnea, causes increased stress on the heart throughout the night. During sleep is normally the time when the heart has less work to do and can "rest."
Among patients with obstructive sleep apnea that do not
have high blood pressure, 45% will develop high blood pressure within four years.
If you examine patients who have hard-to-control blood pressure, that is, taking
more than one medicine for control, 80% have obstructive sleep apnea. When the
obstructive sleep apnea is treated blood pressure decreases.
Heart complications
The risk for congestive heart failure
increases by 2.3 times and the risk of stroke by 1.5 times with obstructive
sleep apnea.
Obstructive sleep apnea can complicate the treatment of atrial fibrillation. Atrial fibrillation is a condition in which the upper part of the heart (atrium) is beating out of coordination with the lower part (ventricle). The treatment is to cardiovert the heart
(resetting the atrium and allowing it to synchronize with the ventricle). After cardioversion, 50% of patients have a recurrence of atrial fibrillation, but patients with obstructive sleep apnea have an 80% recurrence.
Finally, obstructive sleep apnea can increase the
risk of sudden death. Sudden death can kill not only the patient but also their loved ones, for example, if they are driving a car when the death occurs.
Next: How is obstructive sleep apnea diagnosed and evaluated? »
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