Sleep Apnea - is it a symptom or an aggravating factor for cardiovascular disease ?

Obstructive Sleep Apnea

Snoring has been considered as a common effect of deep sleeping by most of people who snore.  Maybe not so many of them realize that snoring has two different side of sharped blade at the end. First, snoring has become an indicator about your bad health situation, secondly, snoring has been one major factor of high divorce number in many countries.  For example, in Saudi Arabia, nearly 40%  of divorce caused by snoring husbands, meanwhile the international rate is 18 - 22%.

As a negative signal to your health condition, snoring which usually comes side by side with Sleep Apnea is divided into 3 types:

1. Central Sleep Apnea (CSA) - 0.4% of cases
2. Obstructive Sleep Apnea (OSA) - 84% of cases
3. Complex or Mixed SA - 15% of cases.

In CSA, breathing is obstructed by the minimum effort of respiratory,  while in OSA, airflow is blocked by physical of organs in the airway.  Beside producing a sound "pollution" in your bed room, OSA in certain level can cause a sudden death. So that it has to be handled accordingly. Occupying the highest number of Sleep Apnea cases, OSA will certainly cause the lack of oxygen supply to your brain while you sleeping (hypoxemia).  OSA definitely has a close relation to body weight, smoking habit, and stop drinking alcohol as the muscle relaxant (also avoid sleeping pills, pain killer, and any unnecessary sedative). I had been a light smoker once, and trust me it that smoking will leverage the possibility of OSA. 

 

Complex Sleep Apnea

This is the third type of Sleep Apnea, and has a close connection to Congestive Heart Failure as we discuss in this blog. Complex Sleep Apnea, actually a combination between central and obstructive sleep apnea. People with Congestive Heart Failure especially Ischemic Dilated Cardiomyopathy are already have a problem with the respiratory and cardiovascular system.  Even without any problem of sleep apnea, the lack of oxygen in their blood stream could be a serious preceding problem. 

I do too. When i got an edema attack, I would got sweat from my chest up to my head tip when I was sleeping.  My breath became wheezing and my upper body created some kind of mechanism to get more oxygen through my skin's pores, which was caused me sweating.  Unfortunately, I get OSA too, and it just makes my oxygen level in my blood stream worse when I am sleeping.

Therapy

For OSA, some therapy including lifestyle corrections, such as losing weight, quite smoking and alcohol drinking, managing an adequate sleeping time, might reduce the sleeping disorder. The other technical ways are by elevating the upper body at about 30-degree higher to prevent the airways collapse when you are sleeping,  by sleeping on the side of your body, and by sleeping on your belly.  The idea is to keep the airway open when you sleep. So far, using the CPAP (Continuous Positive Airway Pressure) machine is very effective, but less comfort and still expensive for some patients.  Surgery is also a way to wider the airway but also expensive.

CPAP

Adaptive Servo Ventilation

 A little bit therapy adjustment has been settled for Complex Sleep Apnea.  Instead of using CPAP, an Adaptive Servo Ventilation (ASV) therapy mode has been chosen to encounter such of sleep apnea. ASV has the capability of counterbalancing the shift between hypoventilation and hyperpnoea by using a variable pressure support to eliminate the ventilator overshoot.

Due to a study of hypoxia in 2012, a conclusion had been made that the lack of oxygen supply to human blood stream, brain, and nerve system will increase cardiovascular damage, causing stroke, high blood pressure, diabetes, and speed up tumor growth, with 5 times elevated risk of deadly cancer awaits.  I my stage of hypoxia due to my Complex Sleep Apnea, the decrement of consciousness, confusion, and mood depression have affected my daily condition.  So that, the conclusion is that sleep apnea will aggravate more to any of cardiovascular disease.