Sleep apnea and heart problems

This article explains heart problems that can be caused by obstructive sleep apnea.

A common sleep problem is bad for your heart, and the number of people that have it has increased by double digits over the past decade.  Studies suggest as many as 26 percent of all Americans may have mild to severe sleep apnea, and only about 10 percent are aware that they have it.
So, as many as 75 million people have a condition that many of know little about.  Sleep apnea is a condition that intrudes into daily living by causing snoring, daytime sleepiness, headache, and poor concentration, but it also can lead to potentially deadly cardiac issues.
Let’s take a look at some of the heart problems that studies have shown sleep apnea can cause:

1. Atrial fibrillation.  Traditional treatment for the irregular heart rhythm called atrial fibrillation consists of blood thinners, medications, and an invasive, expensive procedure called ablation.  There may be a more natural approach.  Atrial fibrillation has been cured in people who are overweight and have sleep apnea.  The treatment consists of weight loss, and sometimes using a device called CPAP to improve oxygen levels during sleep.  According to the Sleep Heart Health Study, the likelihood of developing afib if you have untreated sleep apnea increases fivefold, and treatment improves the likelihood that your rhythm will stay regular into the future.   
2. Hypertension.  There is no doubt that undiagnosed and untreated obstructive sleep apnea can result in high blood pressure.  In addition, apnea can make hypertension very difficult to treat with medication, and one-third of people with a condition called resistant hypertension have undiagnosed sleep apnea. Again, weight loss and using a CPAP mask as prescribed by a sleep specialist can make a huge difference
3. Stroke.  Obstructive sleep apnea (called OSA), has been shown to increase the risk of both stroke and premature dementia.  An analysis published just this month in the journal PLOS One demonstrated that treating the condition with CPAP was associated with a lower incidence of stroke and cardiac events.       
4. Coronary artery disease.  Not only does untreated OSA worsen atherosclerotic coronary disease  (the blockages that cause heart attacks), it also messes with metabolism, worsening cholesterol and sugar levels. This can lead to fatal heart attacks.   Reggie White, the Philadelphia Eagle great, died at age 43, most likely from OSA.
5. Pulmonary hypertension. This condition, in which blood pressure in the lungs can be markedly elevated, is another cardiovascular disease with a well-established relationship to OSA.  Sleep apnea is also associated with congestive heart failure, and inflammation that may have an impact on other non-cardiac problems such as Parkinson’s disease.

Obstructive sleep apnea is often associated with being overweight, and losing weight can be a cure.   If you are a guy with a neck size over 18 inches, or a woman with a neck measuring more than 17 inches, there is an increased chance that you may have OSA.  It is more common in men than women, with up to 34% of men and 17% of women having undiagnosed OSA.

Central sleep apnea, the less common type, and is not related to weight. 

The only way to diagnose sleep apnea is to have a sleep study.  For years, this had to be done in a clinic, but now more people are being screened at home.

Treatment with a CPAP machine requires wearing a mask over your nose or mouth while sleeping, a deal breaker for many.  Newer technologies including smaller masks and mouth appliances have improved treatment, so if this fear has prevented you from getting checked out, it may be a good time to reconsider.

Seeing a sleep specialist now may avert the need to see a cardiologist in the future. 

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Both too much and too little sleep can harm the heart

Too much and too little sleep can hurt the heart according to a recent study.

Otherwise healthy people who have poor sleep habits may be putting themselves at risk for early signs of heart disease, a new study suggests.

Folks who get too much or too little sleep -- or not enough quality rest -- are more likely to suffer from stiffened arteries and calcium deposits on the walls of their major arteries, said study lead author Dr. Chan-Won Kim.

"Coronary calcium develops way before heart attack symptoms occur, and a greater amount of calcium in the coronary arteries predicts future development of heart disease," said Kim, a clinical associate professor in the Center for Cohort Studies at Kangbuk Samsung Hospital in Seoul, South Korea.

The sweet spot appears to be about seven hours of sleep, the researchers reported. People who got more or less sleep tended to have increased signs of potential future heart problems.

Earlier studies have linked poor sleep to bad heart health, but this research goes a step further by looking for precursors of heart disease in people who appear healthy, said Dr. David Meyerson, a cardiologist at Johns Hopkins Bayview Medical Center in Baltimore and a national spokesman for the American Heart Association.

Because the study authors took this route, their implications more directly highlight sleep as a potential risk factor for heart disease, Meyerson said.

"Quality and duration of sleep is not always asked by every physician during a cardiovascular risk assessment session, and perhaps it should be," he said.

While the study uncovered a link between poor sleep and potential heart problems, it did not prove a cause-and-effect connection.

The study involved more than 47,000 young and middle-aged adults who completed a sleep questionnaire and had advanced tests to measure arterial stiffness and detect early artery lesions caused by calcium deposits.

The findings revealed that study participants who:

• got five or fewer hours of sleep a day had 50 percent more calcium in their arteries than those who slept seven hours a day.
• slept nine or more hours a day had at least 70 percent more calcium compared to those who slept seven hours.
• reported poor sleep quality had more than 20 percent more calcium than those who reported good sleep quality.

"Since we studied apparently healthy young and middle-age men and women without major diseases, it is unlikely that other health problems can explain the association between extreme sleep duration and early markers of heart disease," Kim said.

Doctors don't yet know exactly why the proper amount of sleep appears to protect heart health, said Meyerson and Dr. Mark Urman, a cardiologist with Cedars-Sinai Heart Institute in Los Angeles.

During sleep, a complex dance of metabolic changes, hormone releases, body repair and brain refreshment takes place. These processes affect blood pressure, blood sugar, inflammation, stress hormones and a host of other factors that can increase risk of heart disease, the cardiologists said.

"We know our bodies every day need this ability to recharge our batteries, to put everything at ease and calm everything down," Urman said, adding that poor sleep has been linked to heart risk factors like diabetes and obesity.

Sleep should be considered part of an overall heart-healthy lifestyle, Urman said.

"This adds to the importance of getting a good night's sleep on a regular basis, in addition to regular exercise and a heart-healthy diet, in reducing risk of heart disease," he said. "This is one more thing that's part of that package."

People who want to improve their sleep should dim the lights in their living room or bedroom as bedtime approaches, and they should go to bed at the same time every day, Kim said.

"It is also important to avoid exposure to electronic media at bedtime," Kim said. He added that "people who experience inadequate sleep need to avoid caffeine-containing beverages after lunch."

The study findings were published Sept. 10 in the American Heart Association journalArteriosclerosis, Thrombosis and Vascular Biology.

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How sleep can affect your heart

This article describes the negative effects of getting a poor night's sleep, especially on your heart.

You might think that those nights when you don’t get a wink of sleep can’t do you any harm apart from the frustration you feel knowing that you have to work the next day and you might be asleep at the wheel.

However, sleep disorders have been associated with many conditions that you might develop later on in life. There are studies proving that insomnia or very few hours of sleep per night are linked to memory loss or to strokes as you become older.

Thus, it was proved that people who have the tendency to sleep less than seven hours every day are more likely to suffer a stroke.

A new research now shows that fewer hours of sleep every night might also be a cause for heart attacks later on in life.

The study conducted by researchers at World Health Organization revealed that sleeping disorders are as bad for your heart as smoking or leading a sedentary life.

“Sleep is not a trivial issue. Sleeping disorders were associated with greatly increased incidences of both heart attack and stroke. Poor sleep should be considered a modifiable risk factor for cardiovascular disease along with smoking, lack of exercise and poor diet,” said Professor Valery Gafarov.

He also added that a normal person should sleep between 7 and 8 hours every night and, if they don’t manage to do that, they should seek specialized help from a sleep doctor.

The study, which began in 1994, involved 657 men whose ages varied from 25 to 64 years old, from Russia. They had never suffered any heart attack or stroke and they did not have diabetes, which is a disease that can lead to these conditions.

Their sleep quality was rated according to the Jenkins Sleep Scale and it was regarded as either very bad, bad or poor for those who had a sleeping disorder.

They were monitored for heart attacks and strokes over the next 14 years and it was revealed that 63 percent of those who suffered a heart attack also suffered from a sleeping disorder.

Therefore, it was shown that people who had sleeping problems were more than 2 times more likely to have a heart attack and 1.5 to 4 times more at risk of having a stroke that those who had a  normal sleep every night.

These findings are extremely worrying, given the fact that the mortality rate associated with heart attacks is extremely high. It was estimated that it represents half of the causes of death all over the world, making it the leading cause in many countries, including the U.S.

This is why preventive measures are extremely important. We need to sleep well, exercise regularly, avoid smoking and drinking alcohol, eat healthy food and maintain a normal body weight.

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Study: Link between insomnia and stroke

A recent study indicates that those suffering from insomnia have a greater risk of stroke than those who do not have insomnia.

Insomniacs face a much higher risk of stroke than restful sleepers, according to a recent study.

The study, published in the peer-reviewed scientific journal Stroke, an American Heart Association (AHA) publication, sought to link cardiovascular health with sleep-related health.

Past research has shown that not getting enough sleep can lead to a significant number of health problems, including elevated stress levels, symptoms of Alzheimer's disease, and even widespread pain conditions such as fibromyalgia.

Now, researchers from Taiwan's Chia Nan University of Pharmacy and Science, and the Department of Medical Research at Chi-Mei Medical Center, have tied insomnia - a condition of chronic sleep deprivation - to an elevated risk of stroke.

To determine this, the researchers analyzed the medical records of more than 21,000 insomniacs in Taiwan, China. The medical data on these patients was observed for a four-year period, allowing the researchers to conclusively differentiate the intensity of each insomniacs' condition.

The participants were identified as having either chronic or persistent insomnia - disturbed sleep lasting for more than a month; relapse insomnia - return of insomnia symptoms after being free of the condition for more than 6 months; or remission insomnia - becoming non-insomniatic at any point during the study.

These groups were then compared to the medical histories of over 60,000 people who did not have insomnia.

Looking at hospital records, the researchers were able to determine that the patients with insomnia had a 54 percent increased risk of stroke than the non-insomniacs. Even more alarming, insomniacs who were diagnosed with the sleeping disorder when they were young-adults between 18 and 35 years old were a whopping eight times more likely to be hospitalized for stroke, compared to non-insomniacs.

Predictably, the risk of stroke was also found to be greatest in those who suffered from chronic or persistent insomnia or had diabetes.

According to the researchers, although they did not determine a cause-and-effect relationship with this study, past research has suggested that the stress disturbed sleep can have on your heart can cause inflammation, increased blood pressure, and even impaired glucose levels.

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Study: Treated sleep apnea reduces hospital readmission rate in cardiac patients

A study claims that the hospital readmission rate for hospitalized cardiac patients is lower if their sleep apnea is treated.

A study of hospitalized cardiac patients is the first to show that effective treatment with positive airway pressure therapy reduces 30-day hospital readmission rates and emergency department visits in patients with both heart disease and sleep apnea. The results underscore the importance of the "Stop the Snore" campaign of the National Healthy Sleep Awareness Project, a collaboration between the Centers for Disease Control and Prevention, American Academy of Sleep Medicine, Sleep Research Society and other partners.

Results show that none of the cardiac patients with sleep apnea who had adequate adherence to PAP therapy were readmitted to the hospital or visited the emergency department for a heart problem within 30 days from discharge. In contrast, hospital readmission or emergency department visits occurred in 30 percent of cardiac patients with sleep apnea who had partial PAP use and 29 percent who did not use PAP therapy.

"Finding a reduced 30-day cardiac readmission rate in PAP-adherent patients is important for improving both patient care and hospital finances," said principal investigator and senior author Dr. Richard J. Schwab, Professor in the Department of Medicine and co-director of the Penn Sleep Center at the University of Pennsylvania Medical Center in Philadelphia.

The study results are published in the Oct. 15 issue of the Journal of Clinical Sleep Medicine, which is published by the American Academy of Sleep Medicine.

"Severe sleep apnea is solidly associated with serious cardiovascular outcomes, such as heart failure, heart attacks, and heart-related deaths," said American Academy of Sleep Medicine President Dr. Timothy Morgenthaler, a national spokesperson for the Healthy Sleep Project. "This study is a clarion call to detect, diagnose, and especially to treat sleep apnea in patients who are hospitalized for heart problems. Doing so is a win-win-win move; it improves the patient's quality of life, improves health outcomes, and reduces the resources used to manage heart diseases."

The "Stop the Snore" campaign was launched recently to encourage people to talk to a doctor about the warning signs for obstructive sleep apnea, which afflicts at least 25 million adults in the U.S. Sleep apnea warning signs include snoring and choking, gasping or silent breathing pauses during sleep. Pledge to stop the snore athttp://www.stopsnoringpledge.org.

The study involved 104 consecutive patients who reported symptoms of sleep apnea while being hospitalized for a cardiac condition such as heart failure, arrhythmias or myocardial infarction. They were evaluated for sleep apnea using an in-hospital, portable sleep study. Results show that 78 percent of the cardiac patients had sleep apnea (81/104). Eighty percent of sleep apnea cases were predominantly obstructive sleep apnea (65/81), and 20 percent were predominantly central sleep apnea (16/81).

Participants who were diagnosed with sleep apnea were started on PAP therapy, and compliance data were collected via modem or data card. Adequate treatment adherence was defined as using PAP therapy four or more hours per night on at least 70 percent of nights. Thirty-day hospital readmission was defined as a hospitalization or visit to the emergency department for a cardiac cause more than 48 hours after discharge.

According to the authors, reducing hospital readmission rates for cardiac patients is essential for the provision of cost-effective care. They noted that the average total cost per heart failure hospitalization ranges from $13,000 to $18,000. Furthermore, the Centers for Medicare and Medicaid Services (CMS) withholds hospital reimbursement for the care of patients readmitted within 30 days after hospital discharge.

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Sleep apnea screening before surgery

Research claims that people going in for surgery should be checked for sleep apnea due to negative outcomes associated with untreated sleep apnea and serious heart issues.

Scheduled for surgery? New research suggests that you may want to get screened and treated for obstructive sleep apnea (OSA) before going under the knife. According to a first-of-its-kind study in the October issue of Anesthesiology, the official medical journal of the American Society of Anesthesiologists® (ASA®), patients with OSA who are diagnosed and treated for the condition prior to surgery are less likely to develop serious cardiovascular complications such as cardiac arrest or shock.

"OSA is a common disorder that affects millions and is associated with an increased risk of surgical complications, but the condition often goes unrecognized," said Thomas Mutter, M.D., lead author, department of anesthesia and perioperative medicine, University of Manitoba, Winnipeg, Canada. "As many as 25 percent of surgical patients may have OSA, but the vast majority of these patients aren't treated or don't know they have the disorder."

OSA causes the soft tissue in the rear of the throat to narrow and repeatedly close during sleep. The brain responds to each of these "apnea events" by waking the person in order to resume breathing. Since apnea events can happen hundreds of times per night, sleep becomes broken and ineffective and can lead to serious health problems if undetected. Those who are overweight or have high blood pressure are predisposed to developing OSA. It tends to occur in men but women can also develop OSA. Symptoms of apnea may include: heavy snoring, pauses in breathing during sleep and excessive sleepiness during the day.

The study compared postoperative outcomes in 4,211 patients with OSA, who were diagnosed by sleep study either before or after surgery, with a matched control group of patients who did not have the condition. Those who were diagnosed with OSA prior to surgery were prescribed treatment with continuous positive airway pressure (CPAP) therapy. CPAP keeps a patient's airway open by gently delivering pressurized air through a face mask.

The study found that although patients with untreated OSA were at an increased risk of developing cardiovascular complications, patients who were diagnosed and treated with CPAP therapy before surgery were less than half as likely to experience cardiovascular complications such as cardiac arrest or shock.

Additionally, researchers found that respiratory complications were twice as likely to occur in patients with OSA, compared to patients without the condition, regardless of when patients were diagnosed or if CPAP therapy was prescribed.

-MORE- For both cardiovascular and respiratory complications, increasing severity of OSA was associated with increased risk. Age, type of surgery and other diseases were also important risk factors.

The authors acknowledge limitations related to their retrospective study, as well as the potential resources needed to implement widespread screening. Nonetheless, this study adds to the knowledge base of how to care for this increasingly large segment of the population.

An estimated 18 million Americans are thought to have clinically significant OSA and, even more alarming, about 16 million of those people remain undiagnosed.

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Cutting calories can help sleep apnea

Obese adults eating fewer calories can have positive effects on sleep apnea and blood pressure.

A recent study conducted by Brazilian researchers reported that consuming fewer calories could improve sleep apnea and lower blood pressure in obese adults.

Sleep apnea is a potentially serious sleep disorder in which breathing stops and starts during sleep. Additionally, the disorder is associated with high blood pressure, heart problems, and stroke.

The Brazilian study involved 21 obese adults, between 20 and 55 years old, with sleep apnea. Some of the 21 adults reduced their caloric intake by 800 calories over a 16-week period, while the remaining made no changes to their diet.

At the study’s end, investigators found that those who reduced calories had lower blood pressure, had lost more weight, had fewer breathing issues during sleep, and had higher amounts of oxygen in their blood.

Findings of the study were announced at the American Heart Association high blood pressure meeting in San Francisco last week. Data and research presented at medical seminars is deemed inconclusive unit it is published in a peer-reviewed journal.

Dr. Marcia Klein, study co-author and adjunct professor at the University of Rio de Janero State University in Brazil, said the study’s findings reveal that moderate energy restriction in obese adults can improve sleep apnea, as well as blood pressure and heart rate.

Even a slight energy restriction, said Klein, can improve an obese adult’s entire cardiovascular system.

Klein also said that losing weight through dieting and exercise should remain the number one combative against sleep apnea. As a result, systolic blood pressure is often lowered by weight reduction.

Systolic blood pressure is the top number in a blood pressure reading that reflects the force of blood in the arteries when the heart beats. The bottom number in a reading, diastolic blood pressure, measures pressures in the arteries between heart beats. A good blood pressure reading is considered to be below 120/80 mm Hg.

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Study claims that ADHD medication can increase risk of heart issues

A study claims that medication used to treat ADHD might increase the risk of heart complications in children.

Whether drugs used to treat attention deficit hyperactivity disorder boost the risk of heart conditions in children remains a subject of concern. Now, research from Denmark suggests medications such as Ritalin and Concerta make rare cardiac problems twice as likely, although still uncommon.

"The risk of adverse cardiac effects of ADHD medication is real and should not be forgotten," said study lead author Dr. Soren Dalsgaard, an associate professor at Aarhus University.

However, doctors and parents should not be alarmed and take kids off stimulant medication if they have benefits from it and no cardiac symptoms, he said. "But we should continue to monitor cardiovascular status," he added.

The findings aren't definitive because they don't prove cause-and-effect and they seem to conflict with some previous research that looked at fewer heart conditions over shorter periods of time.

The inattention, hyperactivity and impulsivity associated with ADHD can make it hard for children with the disorder to learn and socialize. Stimulant drugs taken on a daily basis can help control these behaviors.

Worldwide, the number of children and teens with ADHD who take stimulant medications is increasing, according to background research in the study. Experts say these drugs can boost heart rate and blood pressure.

"The most common cardiac effects are benign -- very small, clinically insignificant increases in heart rate or blood pressure," said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center of New York in New Hyde Park.

Alarms sounded because of reports of sudden deaths, heart attack and stroke related to ADHD drugs, which has led some physicians to assess heart health before starting young people on the drugs.

But a 2011 study of U.S. children and young adults published in the New England Journal of Medicine found no link between ADHD drugs and heart attacks, sudden death and stroke. And in 2012, a study in the Journal of the American Medical Association found no sign of a link in young and middle-aged adults either.

The new study, published online recently in the Journal of Child and Adolescent Psychopharmacology, followed 714,000 children in Denmark, born from 1990 to 1999, for an average of 9.5 years. Of those, 8,300 were diagnosed with ADHD after age 5.

Of the total with ADHD, 111 kids -- or a little more than 1 percent -- had a heart problem such as high blood pressure, cardiac arrest, irregular heartbeat or general cardiovascular disease.

When the researchers adjusted their statistics to take into account certain differences, they found those who took methylphenidates such as Ritalin or Concerta -- whether diagnosed with ADHD or not -- were about twice as likely to suffer from heart problems.

The researchers didn't examine whether ADHD itself could be linked to heart problems.

In a news release, journal editor Dr. Harold Koplewicz said the study "confirms the small but real risk we have understood for some time through prior reports and clinical experience." Koplewicz is president of the Child Mind Institute in New York City.

The findings raise the question of whether the benefits of the drugs outweigh the possible harms. In the big picture, few children who took the drugs actually developed heart problems, study lead author Dalsgaard said.

"Indeed, the benefits from ADHD medication can be worth the risk of adverse effects, but we should not underestimate the risk of cardiac effects," he said.

Adesman emphasized the rarity of heart problems in ADHD patients. Parents may wish to talk to a pediatric cardiologist if their child has an existing heart problem and they wish to put them on a stimulant for ADHD, he said.

"In my experience, most cardiologists will support treatment with stimulant medication for most children with congenital heart disease -- even for kids who have had open heart surgery to repair a malformed heart," he said.

More research is planned, Dalsgaard said, especially to unravel an unusual finding in the study. Children seemed at higher risk of heart problems if their doctors had lowered their drug dosage. It's not clear if the change in dose contributed to the heart issues or whether there's another explanation.

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What causes poor sleep, and how do I get better sleep?

This article discusses health conditions that cause a person to get poor sleep, and discusses things everyone can do to get better sleep.

With any illness, injury or sniffle, you'll hear one common suggestion: Get plenty of rest. Whether we're nursing a broken bone or trying to recover from the flu, we are led to believe that adequate sleep will put us right on the path to recovery. But just how important is sleep, and what about those of us who can't seem to get quality sleep?

Lack of sleep is linked to several health concerns:

Colds, flu, viruses and infections. One of the first systems to be adversely affected by lack of quality sleep is immune function. When you're tired, you feel worn down -– and that's not just a feeling. Your body is using all energy reserves to fight off the viruses and exposure to germs that might not affect a person with a thriving immune system. Also, if you receive vaccines, the sleep-deprived are slow to respond to the immunity the vaccines are designed to build.

Heart disease. According to Donna Arand, clinical director of the Kettering Sleep Disorder Centers in Dayton, Ohio, lack of sleep causes an inflammatory response to the cardiovascular system. Rises in C-reactive protein due to impaired sleep are warning signs that the body is responding to a perceived injury, infection or disease. In this case, lack of sleep is that perceived threat that results in inflammation. Poor sleep also causes the body to produce more stress hormones, which may contribute to cardiovascular disease. Chronic stress coupled with lack of quality sleep causes double trouble for the heart, arteries and ventricles.

Diabetes. In the past decade, there has been growing evidence that too little sleep can affect hormones and metabolism in ways that promote diabetes. According to a study published in the Lancet in 1999, healthy men with a week of impaired sleep –- only four hours a night –- showed dramatic changes in glucose tolerance. They also had higher-than-normal glucose levels after just one week. This study involved healthy people with no previous record of insulin resistance or history of diabetes.

For those already diagnosed with diabetes, sleep deprivation leads to extremely poor blood sugar control. These studies do not include control factors of the snowball effect that often starts with losing a night's sleep. Sleepy people don't usually reach for healthy foods as snacks and meals. They don't usually choose to walk during their lunch break -– or head to the weight room after work. Tight glucose control involves nutrition and exercise parameters, and both of those are adversely affected by just one night of impaired sleep.

How Can We Improve Our Sleeping Patterns? 
1. Keep the bedroom for sleep and sex. Don't let the bedroom become the home office. Keep the clutter and distraction of that quickly approaching timeline out of the bedroom. Keep a cool temperature, and design the room for its purpose. Walking into your bedroom should be a clear change from the rest of the house.

2. Put down the screens. An hour or more before bedtime, put down the computer, smartphone and TV. Dim the lights throughout the house, and start getting your mind ready to wind down. Some people use blackout shades in the bedroom during the summer months. Before electricity, people stayed awake two or three hours past dusk with candlelight, and their natural circadian rhythms prompted them to sleep. There's a lot of research that links artificial light –- including blue-light from screens -– with interrupted sleep patterns. If we're staying up six or more hours past dusk with fluorescent light glowing, our bodies don't know when it’s time to sleep.

3. Pay attention to what you eat and drink before bedtime. Try not to go to bed ravenous or stuffed. Be aware that a glass of wine might help calm the nerves, but metabolizing alcohol keeps the body in an alert mode while the mind is trying to snooze. Have that glass of wine earlier in the evening. And yes, eating bad pizza right before bed can cause nightmares. So can stuffing yourself with any food minutes before trying to sleep. Your body is trying to do two things: metabolize food and sleep. The food is going to win, and that's a cause for dreams and other disruptions to quality sleep.

4. Move your body. There is substantial evidence that exercise helps you sleep. Even moderate exercise like a daily walk promotes better sleep -– in terms of quality and quantity. Be careful with your exercise timing, so you're not too energized with endorphins to sleep. There's also a direct link between exercise and stress, and stress is a big factor in sleep-deprived people. Move your body. Manage your stress. Get quality sleep.

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Lost sleep increases risk of stroke

A study shows that losing sleep can significantly increase a person's risk of having a stroke.

People with insomnia may be more likely to have a stroke than people who don’t have trouble sleeping, according to a new study.

Study participants who had insomnia had a 54 per cent higher risk of stroke over four years than the people who were not diagnosed with the sleep disorder. 

They also found that, among people with insomnia, stroke was eight times more common in people ages 18 to 34 than in those older than 34.

“Our results add support to the prior findings on the link between insomnia and a wide range of health risks,” said study author Ya-Wen Hsu, an assistant professor at Chia Nan University of Pharmacy and Science in Taiwan.

“Though insomnia is the most common sleep complaint, it should be perceived more as a symptom of another disease,” Hsu told Live Science. People with insomnia should be treated early to prevent other conditions, he said.

Although the number of deaths from stroke in the United States declined by 22.8 per cent between 2000 and 2010, about 795,000 people have a stroke each year, according to the American Heart Association. In 2010, stroke was responsible for one out of every 19 deaths in the US.

In the study, the researchers followed a group of 21,438 people with insomnia and 64,314 healthy people for four years. During the study, 583 (2.7 per cent) of those with insomnia were admitted to a hospital for stroke, whereas 962 (1.5 per cent) of those without insomnia were admitted for stroke.

The link was strongest in people who’d had trouble sleeping for up to six months, according to the study.

The researchers said they don’t know how or why insomnia may be linked with an increased risk of stroke. 

However, they speculated that the sleeping disorder may contribute to inflammation, increase blood pressure and deregulate metabolism and, therefore, affect people’s cardiovascular health, Hsu said.

“We feel strongly that individuals with chronic insomnia, particularly younger persons, see their physician to have stroke risk factors assessed and, when indicated, treated appropriately,” Hsu said in a statement.

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Osteoporosis linked to sleep apnea

A study shows that poor bone health and osteoporosis are linked with sleep apnea.

People with sleep apnea, a common sleep disorder, may be at increased risk for the bone-thinning disease osteoporosis, especially women and older people, a new study suggests.

Sleep apnea causes repeated, brief interruptions in breathing during sleep. Untreated sleep apnea can increase a person’s risk of heart disease, heart attack and stroke.

“Ongoing sleep disruptions caused by obstructive sleep apnea can harm many of the body’s systems, including the skeletal system,” said study co-author Dr. Kai-Jen Tien, of Chi Mei Medical Center in Tainan, Taiwan.

“When sleep apnea periodically deprives the body of oxygen, it can weaken bones and raise the risk of osteoporosis,” Tien said. “The progressive condition can lead to bone fractures, increased medical costs, reduced quality of life and even death.”

For the study, published April 15 in the Journal of Clinical Endocrinology & Metabolism, researchers analyzed the medical records of nearly 1,400 people in Taiwan diagnosed with obstructive sleep apnea between 2000 and 2008. They compared them with more than 20,600 people who did not have the sleep disorder.

Over six years of follow-up, people with sleep apnea were 2.7 times more likely to be diagnosed with osteoporosis. The risk for the bone-thinning disease was highest among women and older people with sleep apnea, according to the study.

“As more and more people are diagnosed with obstructive sleep apnea worldwide, both patients and health care providers need to be aware of the heightened risk of developing other conditions,” Tien said in a journal news release. “We need to pay more attention to the relationship between sleep apnea and bone health so we can identify strategies to prevent osteoporosis.”

However, the study only noted an association between sleep apnea and osteoporosis. It does not prove that one causes the other.

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Study: Poor sleep doubles number of hospitalizations in heart failure patients

A study shows that heart failure patients have double the number of hospitalizations when they do not sleep well.

Poor sleep doubles hospitalizations in heart failure, according to new research in nearly 500 patients presented today at EuroHeartCare 2014.

EuroHeartCare is the official annual meeting of the Council on Cardiovascular Nursing and Allied Professions (CCNAP) of the European Society of Cardiology (ESC). This year's meeting is organized jointly with the Norwegian Society of Cardiovascular Nurses. It takes place 4-5 April in Stavanger, Norway.

Dr Peter Johansson, first author of the study and a heart failure nurse at the University Hospital of Linköping, Sweden, said: "Sleep is important for everyone and we all have to sleep to feel good. We know that sleep problems are common among patients with heart failure. But until now there was no data on whether poor sleep persists over time and how that relates to hospitalizations."

He added: "Our study shows that some patients with heart failure have chronic sleep problems and this more than doubles their risk of unplanned hospitalizations. We need to ask all our heart failure patients whether they sleep well and if not, find out why."

The current study included 499 patients hospitalized for heart failure who participated in the Co-ordinating study evaluating Outcomes of Advising and Counselling in Heart failure (COACH) study. During the initial hospitalization, information was collected on physical functioning, mental health and sleep. Sleep problems were assessed using the question "Was your sleep restless?" from the Centre for Epidemiologic Studies Depression Scale (CES-D). After 12 months the researchers recorded the number and cause of unplanned hospitalizations during the follow up period and assessed sleep again.

The researchers found that 215 patients (43%) had sleep problems at discharge from the initial hospitalization and nearly one-third (30%) had continued sleep problems at 12 months. Patients with continued sleep problems were two times more likely to be hospitalized during the follow up period than those without any sleep problems. Risk was double for all-cause hospitalizations and for cardiovascular hospitalizations. The results were adjusted for physical and mental health factors to ensure that the association was real.

Of the 284 patients without sleep problems at initial discharge, 14% developed a sleep problem during the follow up period. There was a trend for these patients to have more cardiovascular hospitalizations than patients without sleep problems but the finding was not significant.

Dr Johansson said: "Our finding that consistently poor sleep leads to twice as many hospitalizations in patients with heart failure underlines the impact that sleep can have on health. In Sweden we don't generally ask our heart failure patients about sleep and this study shows that we should. If patients say their sleep is poor that may be a warning signal to investigate the reasons."

He added: "Patients may have poor sleep hygiene, which means they do things that prevent them from getting a good night's sleep. These include drinking coffee or too much alcohol late at night, having a bedroom that is too hot or too cold, or having upsetting conversations before going to bed."

Dr Johansson continued: "Patients need to have realistic expectations. One night of poor sleep is unlikely to be a cause for concern, and sleep patterns naturally change with age. But patients who say they consistently have poor sleep should be taken seriously. To help the patients, health professionals for example can look at their medications or send them to a sleep lab for a sleep apnea investigation."

There are a number of possible explanations for the observed association between poor sleep and increased hospitalizations in patients with heart failure. Previous studies have shown that poor sleep can increase inflammatory activity and levels of stress hormones, both of which accelerate the progression of heart failure. It is also known that poor sleep is related to psychological distress, and it could be that these patients worry more about changes to their health and are more likely to visit the hospital.

Dr Johansson said: "Poor sleep may itself lead to worsening heart failure and increased hospitalizations. Alternatively it could be a signal that patients have other problems like sleep apnoea or psychological distress that are keeping them awake. All heart failure patients should be asked about sleep so that if there is a problem we can find out what it is and provide treatment."

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Risks of sleep apnea - stroke, heart attack, pneumonia, dementia.

This article discusses the risks associated with untreated sleep apnea. My only comment for this article  is that "Sleep hygiene" does NOT treat sleep apnea. - JR

Sleep Apnea: The Real Risks Involved

Subscribe FreeBy Mike Tuttle · March 27, 2014 

"18 million Americans suffer from it. It can lead to both physical and psychological problems. Perhaps you, as many do, have it and aren’t even aware of it.

Sleep apnea is a sleep disorder that is characterized by snoring and pauses in breathing at night, waking the person momentarily before they fall back asleep. This disruption of sleep can occur several times a night, 5 to 30 times or more in just one hour. A person, both adults and children alike, can suffer from this disorder for years, even decades, before realizing it.

Studies have shown that sleep apnea can lead to problems like irritability, daytime fatigue, depression, hypertension, heart attack, and stroke, but recent studies have shown that the risks are actually more serious than, well, a heart attack. And while obesity can lead to this disorder, the disorder itself can lead to obesity.

The authors of a review posted in The Lancet Diabetes & Endocrinology journal wrote, “Metabolic health … is largely dependent on behavioral factors such as dietary habits and physical activity. In the past few years, sleep loss as a disorder characterizing the 24-hour lifestyle of modern societies has increasingly been shown to represent an additional behavioral factor adversely affecting metabolic health.”

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“Our findings show that sleep apnea is an independent risk factor for incident pneumonia,” theysaid. “Our results also demonstrated an exposure-response relation in patients with more severe sleep apnea may have a higher risk of pneumonia than patients with sleep apnea of milder severity.”

Heart disease, dementia, diabetes … the negative effects continue to mount up. However, along with the worrisome research comes some hope.

Continuous positive airway pressure devices, or CPAP machines, are currently the most common treatment out there. They consist of a plastic facial mask, which the patient wears at night, connected by a flexible tube to a small bedside machine. Using air pressure, it keeps the patient’s airways open during sleep.

“We know that obstructive sleep apnea is a potential cause of high blood pressure, and we know that CPAP use is associated with reductions in blood pressure in people with hypertension,” sayssleep specialist Vishesh K. Kapur, MD. “And now there is reasonable evidence that this treatment can prevent high blood pressure in patients who don’t already have it.”

Modern CPAP machines also come with a built-in humidifier to help prevent dryness in the throat/nasal passages."

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Sleep issues can lead to heart conditions

This article discusses how snoring and other sleep issues can lead to heart conditions.

Adequate amount of quality sleep is very essential to maintain good health, replenish energy, and restore the mind. It plays a vital role in maintaining a healthy balance of hormones, strengthening the immune system, sustaining proper brain function, and supporting healthy growth and development. Sleep-related disorders are one of the most commonly encountered problems today and can immensely affect your physical and mental health, cognitive capacity, productivity, quality of life, and safety.

Research shows that sleep disorders and heart disease are closely linked and one condition can lead to the other. Your heart, being only a little larger than a fist, works hard to pump almost 2,000 gallons of blood each day. Sleep provides your heart a chance to slow down, and your breathing and blood pressure drop to levels lower than what occurs while you are awake. Lack of sleep can lead to several heart-related conditions which include:

High blood pressure

Chest pain

Hardening of arteries (atherosclerosis or cholesterol-clogged arteries)

Heart attack

Stroke

Coronary heart disease

Congestive heart failure

Congenital heart defects

Studies have shown that habitual loud snorers are at a considerably higher risk of developing heart disease and stroke as compared to people who never or rarely snore. As you sleep, the soft tissue at the back of your head and neck relaxes and gradually narrows the airways, causing you to snore. Certain factors such as obesity, smoking, consumption of alcohol, allergic reactions, and muscle relaxing antidepressants and sedatives are known to increase the risk of persistent snoring. If not treated, snoring usually gets worse over time, causing the muscles to get weaker and making it harder to keep the airways open.

Patients with sleep disorders are often sleepy during the day and have reduced ability to concentrate, remember, or think, and are at a higher risk of falling asleep while driving or working. Studies have shown that proper treatment of sleep apnea greatly reduces your risk of developing heart-related conditions and, in addition, improves pre-existing cardiac disorders. Medical treatment for sleep disorders may involve the following:

• Weight loss if you are overweight.
• Avoiding drugs/habits that increase the risk of sleep apnea such as sleeping pills, sedatives, alcohol, and tobacco smoking.
• Using Continuous Positive Airway Pressure (CPAP) -- a slightly pressurized mask is fit over the nose or over the nose and mouth to hold the airway open and allow the patient to sleep normally.
• Surgery on the upper airway (if your doctor thinks you are a candidate for surgery) -- enlarging the air passage by removing the uvula and some of the surrounding tissue.
• Wearing a dental device or mouth guard that is designed to move the lower jaw slightly down and outwards helps keep the airway open during sleep.
• Getting a polysomnogram -- a sleep study that is usually done overnight in a sleep center. It electronically transmits and records your brain waves, heart rate, breathing patterns, oxygen levels in the blood, your eye and limb movements, and muscle tension as you sleep. A sleep specialist analyzes the quality of your sleep and determines whether or not you have a sleep order.

Sleep disorders are very common and are often ignored by patients. You should talk to your doctor about your risk of having a sleep disorder and get regular medical check-ups. A timely diagnosis and early medical treatment can help you recover from your sleep disorder and reduce the risk of other serious health issues. It is important to remember that good quality sleep is more of a necessity than a luxury for better cardiovascular and overall health.

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The danger of overlooking insomnia

The article details how important it is to get insomnia symptoms checked by a doctor, and discusses what health outcomes could occur from not doing so.

With our busy lives, it can be tempting to shrug off—or ignore altogether—difficulties with sleep. Trouble falling asleep, difficulty staying asleep throughout the night, waking feeling tired and unrefreshed: these are commonly experienced disruptions to sleep for millions of adults. Too often, these sleep problems aren’t taken seriously, or are considered the less-than-ideal price to pay for living full and sometimes hectic lives.

Difficulty falling asleep, waking during the night, waking very early in the morning, and experiencing un-restorative sleep are all symptoms of insomnia, a serious sleep disorder. People may experience these symptoms all at once, or some of them and not others. They may experience them chronically or every so often. They are signs of disrupted, poor quality sleep and they should never be ignored.

New research indicates how high a price we may pay for overlooking signs of insomnia. Scientists at Massachusetts’ Brigham & Women’s Hospital have identified a link between insomnia symptoms and elevated risk of death. Their study, which included more than 23,000 men, found certain symptoms of insomnia associated with higher mortality risk from cardiovascular disease. The men were all participants in the Health Professionals’ Follow-Up Study, a long-term, ongoing research endeavor that investigates issues related to men’s health. In 2004, 23,447 men reported to researchers about their sleep and any insomnia symptoms. Researchers followed up with the men over a period of 6 years, during which time 2,025 of the men died. After adjusting for other mortality-influencing factors including age, lifestyle habits, and other health problems, researchers analyzed data on men’s mortality as related to the presence of the following insomnia symptoms:

• Trouble falling asleep
• Difficulty maintaining sleep
• Waking in the early morning
• Experiencing non-restorative sleep

They found that several symptoms of insomnia were associated with higher rates of cardiovascular death among the men. In particular:

• Men who reported having difficulty falling asleep had a 55% increased risk of death from cardiovascular disease as compared to those men who did not experience this sleep difficulty.
• Men who reported experiencing un-refreshing sleep most of the time were at 32% higher risk for cardiovascular death than men who did not report this symptom.

Poor sleep is well understood to have a serious, negative impact on heart health. Not sleeping well, or enough, raises the risks for a number of cardiovascular problems, including high blood pressure, heart attack, heart failure, and stroke. Protecting the quality of sleep as we age is a critical component of protecting long-term cardiovascular health.

This isn’t the first scientific evidence of a link between poor sleep and increased mortality risk. But the news is particularly worrisome because these symptoms are quite common, particularly as we age. Estimates suggest that 30% or more of American adults experience some insomnia symptoms at least periodically, and for 10-15%, insomnia is chronic. Insomnia grows increasingly common with age: more than half of adults over the age of 65 experience symptoms of insomnia. Women are at higher risk than men for insomnia, due in part to hormonal cycles during childbearing years and to the hormonal changes associated with menopause. This current study included only men, but other research has shown higher risks of mortality associated with poor sleep in both men and women:

• In a number of studies that included both men and women, sleeping fewer than 6 hours and more than 8 hours per night has been associated with increased mortality risk.

• Obstructive sleep apnea in men and in women is linked to significantly highercardiovascular and overall mortality risks. Studies have shown that mortality risks from cardiovascular problems are 2 or more times greater for adults with obstructive sleep apnea. The more severe the obstructive sleep apnea, the greater the mortality risks.

• Research has also linked use of sleeping pills to increased mortality risk. The link between higher rates of mortality and sleeping pill use exists even after factoring out other possible contributors to death risk, including health problems, age, and gender.

Ready for some good news? While sleep problems left untreated may shorten longevity, improving sleep can have powerful positive health benefits. A study conducted recently in the Netherlands found that a regular routine of 7-8 hours of sleep may have as significant an impact on risk for cardiovascular death as not smoking.Regular, sufficient amounts of high-quality sleep have also been linked to reduced riskfor type 2 diabetes, largely because of the positive effect that sleep can have on improving insulin sensitivity.

If you have symptoms of insomnia, don’t ignore them. Share them with your doctor. Make an honest assessment of your sleep habits and make a commitment to taking simple steps to improve your sleep routine and your overall sleep hygiene. Taking steps to improve the quality and quantity of your sleep is one important way to protect your cardiovascular and overall health for the duration of your life. And sleeping well may actually help you extend that duration.

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