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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Link between sleep and blood pressure

A study shows a link between getting enough good-quality sleep and lowering a person's blood pressure.

Looking to lower your blood pressure? Fix your poor sleep habits first, suggests a new study.

Mayo Clinic researchers recently set out to find how reduced sleep quantity and quality could affect a person's blood pressure. After monitoring their eight participants for 16 days, they found that when their subjects experienced prolonged periods of shorter sleep, they also registered substantially higher blood pressure numbers at night. While the size of the study was small, they presented their findings at the American College of Cardiology's 64th Annual Scientific Session in San Diego, California, on March 15.

The eight healthy, normal-weight participants with ages ranging from 19 to 36 experienced a 4-day acclimation period before being split into two groups: one set who slept only four hours each night for nine days, and the other who slept for nine hours each night for those same nine days. They all also completed three days of recovery. Throughout the 16-day period, the researchers monitored each subjects' blood pressure 24 times throughout a daily cycle.

Blood pressure levels naturally rise and fall in a circular pattern throughout the day. They tend to peak in the middle of the afternoon, and reach their lowest points in the middle of the night during one's deep sleep. Now in this study, the sleep-restricted participants registered an average of 115/64 mm Hg during the nighttime while their well-rested counterparts registered an average of 105/57 mm Hg. In addition to confirming that inadequate sleep limited the anticipated decrease in blood pressure with these figures, the experiment revealed a higher nighttime heart rate in sleep-deprived subjects than those who experienced normal sleep.

"We know high blood pressure, particularly during the night, is one of the major risk factors for heart disease, and Americans typically do not get enough sleep," lead author Naima Covassin, Ph.D., said in a statement.

This new study could also further demonstrate why sleep apnea is considered acommon contributor to high blood pressure. According to the National Sleep Foundation, this often-undiagnosed sleeping disorder creates pauses in a person's breathing that lead to snoring and restless nights. That resulting decrease in sleep quantity and quality can lead to hypertension and heart disease, as well as possible mood and memory problems.

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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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Sleep apnea makes high blood pressure difficult to treat

A study shows that sleep apnea could make a person's high blood pressure more difficult to treat.

A new study finds strong links between severe, untreated obstructive sleep apnea (OSA) and high blood pressure even for heart patients on blood pressure medication.

“The current findings suggest that severe OSA may contribute to poor blood pressure control despite aggressive medication use,” says sleep disorder specialist Harneet Walia, MD. She says the study suggests that better strategies to treat sleep apnea can improve blood pressure control. And, in turn, patients’ heart health should improve.

The study results are significant because patients were under the close care of heart specialists, Dr. Walia says. And these doctors were following national guidelines to treat cardiovascular risk.

“The results are of interest as severe levels of obstructive sleep apnea appear to be contributing to uncontrolled blood pressure.” And this leaves the patients more vulnerable to heart problems, she says.

Dr. Walia was the first author of the study, titled “Association of Severe Obstructive Sleep Apnea and Elevated Blood Pressure Despite Antihypertensive Use.” This was a part of the Heart Biomarker Evaluation in Apnea Treatment (HeartBEAT) trial.” The study appears in the American Academy of Sleep Medicine journal.

Apnea patients and poor blood pressure control

Sleep apnea is a serious sleep disorder that occurs when a person’s breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during sleep, sometimes hundreds of times during the night. Their upper airways are completely or partially blocked repeatedly during sleep.

During an apnea episode, the diaphragm and chest muscles work harder as the pressure increases to open the airway. Breathing usually resumes with a loud gasp or body jerk. These episodes can interfere with sound sleep, reduce the flow of oxygen to vital organs, and cause heart rhythm irregularities.

Of the 284 study subjects, those with serious apnea were four times more likely to have resistant elevated blood pressure – even though they were taking three or more medications, says Dr. Walia. All these patients either had or were at risk for cardiovascular disease.

Previous research has also linked obstructive sleep apnea to resistant hypertension, Dr. Walia says.

“Our study is different because these are folks who had cardiovascular disease, and who were followed by cardiologists, yet severe apnea may have contributed to suboptimal blood pressure control,” she says.

“This is an important finding from a clinical perspective because patients with poor blood pressure control taking multiple anti-hypertensive medications are particularly vulnerable to increased cardiovascular risk. Strategies to treat obstructive sleep apnea should be strongly considered because the improved control in blood pressure could potentially lead to improvement in cardiovascular morbidity and mortality,” she says.

Should you be evaluated?

Dr. Walia suggests that patients who have high blood pressure, are on anti-hypertensive medication and who have signs of obstructive sleep apnea be evaluated. Snoring, pauses in breathing during sleep, restlessness during sleep, excessive daytime sleepiness and impaired concentration are all signs of OSA, says Dr. Walia.

“It’s an important finding, especially for people who are taking multiple blood pressure medications,” she says. “They may be at risk for cardiovascular disease, anyway. Future research is definitely needed to gain a better understanding of the mechanistic pathways of this link.”

She says more studies are also needed on how sleep apnea treatment relates to blood pressure control and how it impacts people on different types of blood pressure medications.

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Blood pressure and cognitive decline

High blood pressure as an adult may indicate a weaker brain with more cognitive decline later in life.

Let your blood pressure get too high in midlife, and you might pay the price in mental decline later on, a new study suggests.

The study of almost 14,000 people found that high blood pressure in those aged 48 to 67 was tied to a late-life drop in mental ability. Over 20 years, people with high blood pressure in midlife experienced a modest but significant 6.5 percent decline in scores on tests of mental function, compared with people with normal blood pressure.

"High blood pressure might be an important risk factor for dementia, since mental decline is a known risk factor," said lead researcher Dr. Rebecca Gottesman, an associate professor of neurology and epidemiology at Johns Hopkins University School of Medicine in Baltimore.

However, she stressed that because "we know how to treat high blood pressure," bringing it under control might also cut a person's risk for dementia.

For the study, Gottesman's team collected data on people taking part in a major U.S. heart disease study. The participants were followed for as long as 23 years and their mental abilities were tested three separate times.

Gottesman's group found that people whose blood pressure was controlled with medication had less mental decline than those with uncontrolled high blood pressure. The effect was stronger among whites than blacks, the researchers noted.

Blood pressure levels in middle age may be especially important to later-life mental acuity, Gottesman said.

"This may be why some clinical trials that have studied the role of blood pressure medications [in older people] have failed to find a benefit in reducing mental decline and dementia," she reasoned. "The trials may simply not be long enough -- it may be most important to start treatment of high blood pressure when people are middle-aged."

However, the jury is still out on whether blood pressure medication given in middle age can help boost late-life thinking and memory.

"In our study, people who were on medications to treat high blood pressure did have less mental decline than did people not on medications," Gottesman said. "But it's possible those people had been on medications for years."

Still, "our data suggest that, overall, being on any medications for high blood pressure may be protective," Gottesman said.

The report was published online Aug. 4 in JAMA Neurology.

Dr. Philip Gorelick is medical director of the Hauenstein Neuroscience Center at Michigan State University College of Human Medicine in Grand Rapids.

He believes that the new study "provides some evidence that those who were observed and treated for high blood pressure were better off in the long run from a mental standpoint than those who were not treated for high blood pressure."

Gorelick, who authored an accompanying journal editorial, said that doctors have long known that treating high blood pressure is key to cutting people's odds for stroke and heart attack.

Now "another, but less well-documented benefit, of blood pressure lowering may be the preservation of mental function as we age," he said. "With additional study, we may be better positioned to tell our patients whether control of blood pressure not only prevents stroke and heart attack, but also helps to preserve their brain."

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Sleepless nights after divorce are linked to raised blood pressure

A study looked into people who have long-term sleeplessness following a divorce and found they are more at risk for high blood pressure.

People who suffer long-term sleep problems after a divorce are at risk for a rise in blood pressure, a new study suggests.

Previous research has linked divorce to major health problems and even early death, but few studies have examined the reasons for this link. Sleep trouble may be one of the causes, according to the University of Arizona investigators.

Their study included 138 people who had been separated or divorced for about 16 weeks. They reported on the quality of their sleep during three lab visits over seven-and-a-half months. Their blood pressure also was checked during those visits.

The researchers did not see a link between sleep problems and blood pressure in the participants' early lab visits. However, there was a delayed effect, they said.

"We saw changes in resting blood pressure were associated with sleep problems three months earlier. Earlier sleep problems predicted increases in resting blood pressure over time," study co-author David Sbarra, an associate professor of psychology, said in a university news release.

The longer participants' sleep problems lasted, the more likely they were to have a rise in blood pressure.

"What we found was if you're having sleep problems up to about 10 weeks after your separation, they don't appear to be associated with your future increase in blood pressure," Sbarra said. "However, after 10 or so weeks -- after some sustained period of time -- there seems to be a cumulative bad effect."

The study, published recently in the journal Health Psychology, only established an association between divorce-related sleep problems and higher blood pressure, not a direct cause-and-effect relationship.

"In the initial few months after a separation, sleep problems are probably pretty normal, and this is an adjustment process that people can typically cope with well," Sbarra said.

Sleep problems that persist for an extended period might mean something different, he added. "It may mean that people are potentially becoming depressed, that they're struggling with getting their life going again, and it is these people that are particularly susceptible to health problems," he explained.

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Study claims no association between insomnia and hypertension

A study looked into hypertension and insomnia and found no association between the two conditions.

A new research shows that insomnia is not associated with hypertension.

Insomnia is a sleeping disorder in which a person has difficulty falling asleep. Researchers at St. Michael's Hospital found that people with the disorder do not have an increased risk of developing high blood pressure.

For the study, researchers assessed nearly 13,000 Americans who were part of the National Health and Nutrition Examination Survey. The survey consisted of a series of studies that examined the health of children and adults via interviews and physical examinations. The researchers examined the information about the participants' insomnia symptoms, hypertension and prescription drug use.

"After adjusting for many factors, including whether or not participants were receiving blood pressure pills or sleeping pills, there were generally no associations between insomnia and high blood pressure, even among people who were suffering from insomnia the most often," Dr. Nicholas Vozoris concluded, according to the press release. "These results should reassure patients and their doctors that insomnia and high blood pressure are unlikely to be linked."

Dr. Vozoris explained that the findings showed that doctors need not worry much about the side effects that insomnia medications might have on the heart. Moreover, the doctors can prescribe what they think is the best medication for their patients and focus on improving their patients' insomnia.

"By showing there is no link between this very common sleep disorder and high blood pressure, physicians can be more selective when prescribing sleeping pills and refrain from prescribing these medications from a cardio-protective perspective," Dr. Vozoris said.

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PTSD symptoms could be reduced by high blood pressure medications

This article discusses a hypertension medication that coincidentally also treats PTSD symptoms.

There are currently only two FDA-approved medications for the treatment of posttraumatic stress disorder (PTSD) in the United States. Both of these medications are serotonin uptake inhibitors.. Despite the availability of these medications, many people diagnosed with PTSD remain symptomatic, highlighting the need for new medications for PTSD treatment.

The renin-angiotensin system has long been of interest to psychiatry. Some of the first drugs targeting this system were the angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), commonly prescribed treatments for high blood pressure.

In the 1990's, multicenter studies evaluating ACE inhibitors suggested that they improved quality of life as well as other medical outcomes, but these medications did not prove to be sufficiently effective for the treatment of psychiatric disorders to become established treatments.

Recently, however, investigators at Emory University observed that individuals diagnosed with PTSD, and who happened to also be treated with ARBs or ACE inhibitors, exhibited fewer PTSD-like symptoms.

This led the researchers to investigate the underlying mechanisms using an animal model of PTSD in order to expand upon this clinical finding.

Dr. Paul Marvar, first author and Assistant Professor at The George Washington University, explains their findings, "Our current preclinical results show that the ARB losartan, given acutely or chronically to mice, enhances the extinction of fear memory, a process that is disrupted in individuals with PTSD. Overall these data provide further support that this class of medications may have beneficial effects on fear memory in PTSD patients."

Fear extinction is a process by which a memory associated with fear is gradually 'overwritten' in the brain by a new memory with no such association. For example, exposure therapy is a form of fear extinction, whereby repeatedly exposing a patient in a safe manner to a feared object or situation slowly reduces or eliminates their fear. A medication that could potentially enhance the extinction of fear would be welcome to the millions of individuals who continue to suffer with symptoms of PTSD.

"It is exciting to see the renin-angiotensin being explored in new ways in the search for new treatment for PTSD," commented Dr. John Krystal, Editor of Biological Psychiatry. "There is a tremendous need for more effective treatments for PTSD symptoms."

Future studies are still necessary before clinical use could be recommended, but there is hope that by targeting this pathway, it may provide a safe and powerful adjunctive novel therapy for the treatment of PTSD.

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High blood pressure, snoring, and sleep apnea during pregnancy

This article examines how high blood pressure and snoring during pregnancy can indicate sleep apnea in pregnant women.

Half of hypertensive pregnant women who snore and one quarter of those who do not snore have unrecognized obstructive sleep apnea (OSA), suggesting such women should be tested for this condition. Findings from this cohort study were published online May 29 in BJOG.

OSA is a sleep disorder associated with reduced nocturnal blood oxygen levels and other morbidity. The prevalence of OSA increases during pregnancy, affecting up to one third of women by the third trimester.

"We know that habitual snoring is linked with poor pregnancy outcomes for both mother and child, including increased risk of C-sections and smaller babies," lead author Louise O'Brien, PhD, associate professor, Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, said in a news release. "Our findings show that a substantial proportion of hypertensive pregnant women have [OSA] and that habitual snoring may be one of the most telling signs to identify this risk early in order to improve health outcomes."

The study goal was to examine the prevalence of OSA among women with and without hypertensive disorders of pregnancy followed-up at obstetric clinics at an academic medical center. Pregnant women who were normotensive and those with hypertensive disorders (chronic hypertension, gestational hypertension, or preeclampsia) completed a questionnaire regarding habitual snoring. They also underwent overnight ambulatory polysomnography to determine the presence and severity of OSA.

Snoring and Hypertension Linked to OSA

Of 51 women with hypertensive disorders, 31 (61%) had OSA compared with 3 (19%) of 16 normotensive women (P = .008 by chi-square). Although nonsnoring women with hypertensive disorders generally had mild OSA, more than 25% of snoring women with hypertensive disorders had moderate to severe OSA.

Among women with hypertensive disorders, those who snored had a substantially greater apnea/hypopnea index than did nonsnorers (19.9 ± 34.1 vs 3.4 ± 3.1; P = .013), as well as a significantly lower oxyhemoglobin saturation nadir (86.4 ± 6.6 vs 90.2 ± 3.5; P = .021).

After stratification by obesity, the pooled relative risk for OSA in snoring versus nonsnoring women with hypertension was 2.0 (95% confidence interval, 1.4 - 2.8), or double the risk.

Women with chronic snoring were most likely to have chronic hypertension, whereas women with gestational hypertension were more likely to have the onset of snoring during pregnancy.

Limitations of this study include an inability to determine causality. In addition, only about one third of women who were invited to take participate actually did so.

"Hypertensive pregnant women who report snoring should be evaluated for [OSA,] since sleep apnea can be treated during pregnancy," Dr. O'Brien said. "Prompt recognition, evaluation, and management will not only improve health benefits for both moms and babies but may also help cut the high healthcare expenses of operative deliveries, taking care of babies who are admitted to the [neonatal intensive care unit] and other associated health risks."

In an accompanying commentary, F. Facco, MD, from the Department of Obstetrics and Gynecology, University of Pittsburgh, Pennsylvania, reviews current knowledge of sleep-disordered breathing (SDB) in pregnancy.

"[W]ell-designed clinical trials of CPAP use in pregnancy are needed to determine whether treatment of SDB during pregnancy can improve pregnancy outcomes; however, in the meantime we have to recognise that as our obstetrical patient population is becoming more obese, we will encounter more women with symptomatic SDB in pregnancy," Dr. Facco writes. "It is well documented that patients with symptomatic SDB, typically those who snore and report persistent complaints of significant sleep disruption and excessive daytime sleepiness, can benefit from CPAP in terms of sleep quality and daytime function. Therefore, in addition to encouraging women already prescribed CPAP to continue their therapy during pregnancy, obstetricians who suspect a patient may suffer from symptomatic SDB should refer her to a sleep specialist for diagnosis and possible treatment."

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Pregnant women with hypertension and who snore may have a sleep disorder

A study shows that nearly half of pregnant women with hypertension and who snore may also have an undiagnosed sleep disorder.

One in two hypertensive pregnant women who habitually snore may have unrecognized obstructive sleep apnea, a sleeping disorder that can reduce blood oxygen levels during the night and that has been linked to serious health conditions, new University of Michigan-led research shows.

One in four hypertensive pregnant women who don't snore also unknowingly suffer from the sleeping disorder, according to the study that appears in the British Journal of Obstetrics and Gynecology.

"We know that habitual snoring is linked with poor pregnancy outcomes for both mother and child, including increased risk of C-sections and smaller babies," says lead author Louise O'Brien, Ph.D., M.S., associate professor at U-M's Sleep Disorders Center in the Department of Neurology and adjunct associate professor in the Department of Obstetrics & Gynecology at the U-M Medical School.

"Our findings show that a substantial proportion of hypertensive pregnant women have obstructive sleep apnea and that habitual snoring may be one of the most telling signs to identify this risk early in order to improve health outcomes."

Habitual snoring – snoring three or more nights a week – is the hallmark symptom of obstructive sleep apnea, which has been shown to increase in frequency during pregnancy. and affects up to one-third of women by the third trimester.

O'Brien's previous studies have found that snoring during pregnancy may influence delivery and baby's health, with a higher risk for C-sections and delivering smaller babies. Women who begin snoring during pregnancy are also at a strong risk for high blood pressure and preeclampsia, O'Brien's research has shown.

"Hypertensive pregnant women who report snoring should be evaluated for obstructive sleep apnea since sleep apnea can be treated during pregnancy," says O'Brien, who is also a member of the Institute for Healthcare Policy and Innovation.

"Prompt recognition, evaluation, and management will not only improve health benefits for both moms and babies but may also help cut the high healthcare expenses of operative deliveries, taking care of babies who are admitted to the NICU and other associated health risks."

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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.”

...

“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 necessary for mental health and well-being

This article discusses how crucial good sleep is for a person's mental health and well-being, and the consequences of not having good quality sleep.

Having a good quality and restorative sleep is essential for one to be able to function well throughout the day. Failure to do so will lead to numerous impacts to health, both long- and short-term.

According to the Sleep Disorder Society Malaysia (SDSM) president Dr Muhammad Muhsin Ahmad Zahari, some of the short-term negative impacts include short attention span, memory recall and learning; while its long-term effects have long been associated with hypertension, ischaemic heart disease, stroke, obesity, diabetes, weakened immune system, and cancer.

Dr Muhammad Muhsin added that sleep disorder can also increase the risk of accidents.

"People who suffer from insomnia are seven times more likely to become involved in an accident which then resulted in death or serious injury," he said at the launch of the `World Sleep Day Celebration and Sleep 2014 Conference' at Cititel Hotel, here, today.

He revealed that sleep disorder actually constitute a global epidemic that threatens health and quality of life for up to 45% of the world's population, thus it is essential for everyone to have a better understanding of sleep conditions.

"Sleep is a basic human need and it is crucial not only to our health and well-being, it also plays an important role in the metabolic regulation in children," said Dr Muhammad adding that SDSM is working closely with the relevant authorities, associations and organisations in improving the quality of service of sleep medicine.

"With regards to the quality service in sleep medicine, facilities such as sleep laboratory are vital. As our population grows, there is definitely a need to increase the number of sleep laboratory in public hospitals to cater to the need of the people." he added.

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Sleep apnea can worsen skin cancer outcomes

A recent study showed that people with sleep apnea had significantly worse melanoma and skin cancer outcomes.

A bad night’s sleep can be the result of stress, poor diet, or simply not getting enough hours of rest. If you begin to fall into a pattern of back-to-back sleepless nights and find yourself experiencing daytime sleepiness, slow reflexes, and poor concentration, you may be suffering from a common sleep disorder — sleep apnea. The common yet underrecognized condition affects the way that approximately 22 million Americans breathe when they sleep at night, according to the American Sleep Apnea Association. Eighty percent of moderate and severe cases of obstructive sleep apnea (OSA) are undiagnosed, putting patients at risk for high blood pressure, chronic heart failure, and other cardiovascular problems.

The sleep disorder has also been linked to a higher prevalence of cancer mortality. In sleep apnea, there is a lack of adequate air flow traveling into the lungs through the mouth and nose, causing a reduction in oxygen levels in the blood. This common trait in sleep apnea is known to play an important role during the various stages of tumor formation and progression. In fact, the severity of the sleep disorder may predict the risk of malignant skin melanoma, according to a new study.

Findings presented at the European Respiratory Society (ERS) Annual Congress in Barcelona unveiled the link between skin cancer and sleep apnea in humans. Previous studies have examined the link between the sleep disorder and both mortality and incidence rates from cancer. However, this is the first study to analyze the relationship between a specific cancer — skin melanoma — and sleep apnea in humans. The researchers measured the aggressiveness of melanoma, along with the presence and severity of sleep apnea, in 56 patients diagnosed with malignant skin melanomas.

Sixty-one percent of patients with malignant skin melanomas had sleep apnea, while 14.3 percent had severe sleep apnea. The results of the study revealed that as the severity of sleep apnea increased, the progression of skin melanoma also increased. Extreme sleep apnea was also associated with a higher growth rate or depth of invasion of the tumor, reports Science Daily.

"This is the first study in a human sample to show that sleep apnea can worsen the outcomes of melanoma." said lead author of the study, Dr. Francisco Campos-Rodriguez, from the Hospital de Valme in Seville, Spain.

While most patients with sleep apnea suffer specifically from OSA, central sleep apnea is the second most common type of sleep apnea diagnosed. This type of sleep disorder happens when the brain doesn’t send the right signals to the muscles that are responsible for controlling breathing, according to the University of Maryland Medical Center. Some people even suffer from a combination of the two types of sleep apneas — known as complex sleep apnea.

The research findings by Campos-Rodriguez and his colleagues could have important clinical implications, if applied to a larger sample size. "If the results are confirmed in larger studies, this would have important clinical implications, particularly as sleep apnea can be easily treated and this could open up new therapeutic possibilities for people with both conditions,” Campos-Rodriguez said. The researchers have begun a bigger trial that will further analyze the link between the sleep disorder and skin melanoma, involving 450 patients with cutaneous melanoma. This study could provide a breakthrough in the treatment of skin cancer patients with sleep apnea.

According to the American Cancer Society, approximately 120,000 new cases of melanoma will be diagnosed in the United States in a year. The most preventable cause of skin melanoma is exposure to the sun.

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Study claims insufficient sleep is more likely in African Americans

A study shows that African Americans are more likely than whites to get insufficient sleep.

Black Americans are more likely than whites to get too little sleep and this disparity is greatest among people in professional occupations, a new study shows.

Lack of sleep has been linked with increased risk of health problems, such as obesity, high blood pressure, diabetes, heart disease and even death.

For the study, researchers analyzed data collected from nearly 137,000 American adults between 2004 and 2011, and found that 30 percent of them were short sleepers (getting less than seven hours of sleep a night), 31 percent were optimal sleepers (getting about seven hours of sleep a night), and 39 percent were long sleepers (getting more than seven hours of sleep a night).

Further analysis revealed that 37 percent of black participants were short sleepers, compared with 28 percent of white participants. Among people in professional or management positions, blacks were much more likely than whites to be short sleepers (42 percent versus 26 percent), according to the Harvard School of Public Health researchers.

Blacks working in support services or as laborers were also more likely than whites to be short sleepers, 37 percent versus 26 percent and 35 percent versus 32 percent, respectively. The only job sectors in which blacks and whites had similar rates of short sleep were the retail and food industries.

The findings were published online Sept. 9 in the American Journal of Epidemiology.

"With increasing numbers of blacks entering professional and management roles in numerous industries, it is important to investigate and address the social factors contributing to the short sleep disparities in blacks compared with whites in general, and particularly in professional settings," study author Chandra Jackson, a postdoctoral research fellow in the department of nutrition, said in a Harvard news release.

Possible sleep-disrupting factors that affect blacks more than whites include: job stress; workplace discrimination or harassment that can increase job stress; limited control over job demands or prestige; long work hours; stress at home; and limited access to professional and social networks that provide emotional or financial support.

In addition, blacks are more likely than whites to do shift work and are also more likely to live in city neighborhoods with high noise levels at night, the researchers noted.

And, the study authors pointed out, it's also possible that a high work ethic among blacks -- a strong desire to succeed against all odds -- could lead to stress, disrupted sleep and harmful health effects.

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The Dangers of Sleep Apnea

This article discusses what exactly sleep apnea is and why it is a dangerous condition.

If you suffer from sleep apnea, you may be unaware of the fact. Sleep apnea is a sleep disorder whereby a person suffers from repeated interruptions to their sleep because of breathing difficulties. The patient typically stops breathing for around 10 seconds before the brain is forced to wake up and kick start the breathing process again. Most people with sleep apnea also snore heavily.

Symptoms of Sleep Apnea

Unless your partner has told you that you snore and stop breathing on a regular basis, look out for the following signs of sleep apnea:

• Sore throat in the morning
• Feeling very tired when you wake up
• Waking up repeatedly during the night gasping for air
• Anxiety and depression
• Men may suffer from impotence

Snoring is No Joke

Snoring is often considered to be a bit of a joke, but the reality is that excessive snoring and associated sleep apneais no joke whatsoever. It is bad for your health and extremely bad for your close relationships—most people find it very taxing to sleep with a partner who snores heavily and wakes up multiple times per night snorting and gasping for oxygen. Even if you felt romantic when you first went to bed with them, after a few nights of snoring and snorting, the passion will soon be long gone.

Health Problems Caused by Sleep Apnea

Sleep apnea is linked to a number of serious health problems, including:

• Weight gain –   Gaining weight can lead to snoring, which in turn can exacerbate sleep apnea. Unfortunately, poor sleep affects the endocrine system and the body is more likely to crave sugary and starchy foods, which leads to weight gain. So it all becomes a vicious circle.
• Heart disease – People with sleep apnea are much more likely to suffer from heart attacks. This could be as a result of low oxygen levels, but research has also found that some sleep apnea patients have irregular heart rhythms.
• Strokes – Having sleep apnea puts you at greater risk of suffering from a stroke because oxygen deprivation has an effect on blood flow through the arteries and brain.
• High blood pressure – Frequent patterns of interrupted sleep can play havoc with the endocrine system, which affects blood pressure. Oxygen deprivation can also cause spikes in blood pressure.
• Type 2 diabetes – There is no definite link betweensleep apnea and type 2 diabetes, but at least 80% of diabetic patients suffer from sleep apnea.

Other Complications of Sleep Apnea

Aside from the serious health problems listed above, sleep apnea can be hazardous to your wellbeing in a number of other ways. As we have already mentioned, sleep apnea can lead to impotence in men, which is unlikely to be great for your long-term relationships. Excessive tiredness can also contribute to problems at work, or in extreme circumstances, directly cause car accidents if you end up falling asleep whilst driving.

If you suspect you may be suffering from sleep apnea, it is a good idea to make an appointment for a full medical check-up. Ignoring the problem is not likely to make it go away, whereas if you seek treatment, you could be on the way towards obtaining a CPAP breathing machine and seeing a significant improvement in your sleep patterns.

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Women's Sleep and Heart Health

This article discusses how the amount and quality of sleep women get is extremely important to their heart health.

Getting enough sleep on a regular basis is one important way to protect the health of your heart. Poor and insufficient sleep is associated with a range of cardiovascular problems, including high blood pressure,heart attack, and heart failure. Both men and women are at increased risk for these conditions. But we continue to learn that when it comes to health problems associated with sleep, the particular risks to men and women are not always the same. A new study suggests that for women who already have heart disease, poor sleep may be particularly dangerous to their heart health.

Statistics from the American Heart Association reveal that heart disease is a bigger problem for women than most of us think:

Heart disease is the No. 1 killer of women, and is more deadly than all forms of cancer combined.

• Heart disease causes 1 in 3 women’s deaths each year, killing approximately one woman every minute.
• An estimated 43 million women in the U.S. are affected by heart disease.
• Since 1984, more women than men have died each year from heart disease.
• Only 1 in 5 American women believe that heart disease is her greatest health threat.

Research indicates that poor-quality sleep—and waking too early in particular—is associated with increased inflammation among women with heart disease. There was no similar association found for men, suggesting that women with heart disease and sleep problems may be at particular risk for inflammation that can be damaging to the heart.

Researchers at the University of California San Francisco investigated the relationship between sleep quality and inflammation linked to coronary heart disease. They also sought information about how an association between sleep and inflammation might differ between men and women. Their investigation included 980 men and women at the outset, and 626 completed the 5-year study. All of those included were suffering from coronary heart disease. The average age of men in the study was 66. Women were slightly younger, with an average age of 64. Researchers measured sleep quality by asking participants to rate their sleep over the previous month. They also asked for reports of some of the most common sleep problems, including difficulty falling asleep, difficulty staying asleep, waking frequently throughout the night, and waking too early in the morning. Researchers assessed inflammation levels using 3 biomarkers: Interkeukin-6, C-reactive protein, and Fibrinogen.

After 5 years, researchers repeated tests for inflammation and once again sought reports on sleep quality and sleep problems. When they analyzed data for both men and women together, researchers found no links between inflammation and sleep quality. However, when they analyzed data taking gender into account, researchers found a relationship between inflammation and sleep existed for women, but not for men:

• Women who reported poor sleep quality experienced greater increases in levels of inflammation over the 5-year period than men.
• Women who reported their sleep quality as “very poor” or “fairly poor.” experienced increases to their inflammation markers that were 2.5 times greater than men who reported the same levels of poor sleep.
• The association between inflammation and sleep remained intact for women even after taking into account other factors that might influence inflammation, including age, cardiac function, body mass index, medication use, and lifestyle factors.
• The link between inflammation and sleep for women with coronary heart disease was particularly strong among those women who had a tendency to wake too early in the morning.
• Women were more likely than men to report waking too early. They were slightly more likely than men to report waking frequently during the night and having difficulty falling asleep.
• Because the majority of women in the study were post-menopausal,researchers hypothesized that low estrogen levels might explain the link between poor sleep and inflammation. This question was not examined in the study itself.

This is not the first study to suggest that lack of sleep may be particularly dangerous for women’s heart health. Researchers in the United Kingdom also found inflammation linked to lack of sleep in women. This large-scale study included 4,600 adult men and women. As in the current research, changes to women’s inflammation levels were linked to sleep problems, whereas no such association was found in men. In an Italian studythat included both men and women, women with resistant hypertension—a form of high blood pressure that is not responsive to medication—were 5 times as likely to have sleep problems. There was no similar link between resistant hypertension and poor sleep in men.

This latest study provides some important information about one way that sleep may affect heart health. It’s also another reminder that when it comes to health in general and sleep in particular, gender matters.  In recent years there has been an increased focus on learning more about the differences in sleep between men and women, and how these differences may contribute to specific health risks. Evidence suggests that circadian rhythms in men and women are markedly different. Our circadian clocks are remarkably sensitive and precise, and even a small difference in circadian timing can have a significant impact on sleep. We need to continue to pay attention to gender differences in sleep, as a way to better understand, diagnose, and treat both sleep problems and the broad array of health concerns now associated with poor sleep.

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