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Sleep-Related Breathing Problems Linked to Heart Disease
Jan. 19, 2001 -- For millions of people with sleep-related breathing problems, getting a good night's sleep is an elusive dream. Even those with mild to moderate forms of the common condition called sleep apnea may experience chronic snoring, frequent morning headaches, and debilitating daytime fatigue. Now a new study suggests that these people also are at increased risk for heart attacks, stroke, and other cardiovascular events, just like those with more severe sleep-related breathing problems.
According to the study, even those with mild to moderate respiratory events during sleep had a twofold higher risk of heart failure. The findings from the National Heart, Lung, and Blood Institute-funded Sleep Heart Health Study Research Group also showed that these individuals were at 1.5 times the stroke risk of those with no sleep-related breathing problems.
"Approximately three-fourths of the participants in this study had mild to moderate sleep disorders," lead author Eyal Shahar, MD, tells WebMD. "Only about 5% had symptoms severe enough to be considered severe sleep apnea. Most had few or no symptoms. Sleep-disordered breathing is something that affects most of us in some way or another. We have shown that even when it is mild, it could have health consequences."
Some 12 million Americans are believed to suffer from sleep apnea, a disorder characterized by brief interruptions of breathing during sleep. Many more may have less severe sleep-disordered breathing problems that go unrecognized and undiagnosed. The sleep disturbances are most common in men and in those who are overweight, but they can occur in anyone at any age.
"The vast majority of people with this disorder are never diagnosed," American Sleep Apnea Association president Safwan Badr, MD, tells WebMD. "Many of these people have no symptoms at all and would be surprised to find they have sleep-related breathing problems that may be affecting their health." Badr, a professor of medicine at Wayne State University in Detroit, reviewed the study for WebMD.
Several recent studies have shown that people diagnosed with severe sleep apnea are at increased risk for high blood pressure and other cardiovascular events, such as stroke and heart attack. But little is known about the risk for people with mild breathing disorders during sleep.
In this study, published in the January issue of the American Journal of Respiratory and Critical Care Medicine, Shahar and colleagues assessed sleep-disordered breathing and self-reported cardiovascular disease events in roughly 6,500 people who were over the age of 40. Sleep patterns were recorded at home by study participants, during a single night, using a portable monitor.
The majority of participants had mild to moderate disordered breathing during sleep, averaging more than four events per hour. A total of 1,023 (16%) also reported at least one cardiovascular event, ranging from heart attack, angina, and heart failure to stroke, bypass surgery, or angioplasty. The researchers found that sleep-disordered breathing was most strongly linked to heart failure and stroke. Study participants with five or more respiratory episodes per hour had a slightly higher risk of heart disease, compared to those with no sleep-related respiratory problems.
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