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Treating Sleep Apnea May Lower Heart Risks

For obese patients, weight loss is recommended, too, expert says

WebMD News from HealthDay

By Amy Norton

HealthDay Reporter

WEDNESDAY, June 11, 2014 (HealthDay News) -- Treating sleep apnea might lead to more than a better night's sleep. It can also reduce blood pressure and other threats to heart health, two new studies show.

Sleep apnea is a common disorder in which the airways constrict during sleep, leading to repeated stops and starts in breathing. The telltale signs include chronic loud snoring, with periodic gasps or choking -- and, for many people, daytime drowsiness because of poor sleep.

But the effects go beyond fatigue. Studies suggest those pauses in breathing stress the nervous system, boosting blood pressure and inflammation in the arteries.

What's more, people with sleep apnea appear to be at increased risk of heart attack and stroke.

But the new studies, reported June 12 in the New England Journal of Medicine, turned up some good news. The most common treatment for sleep apnea -- continuous positive airway pressure (CPAP) -- can curb high blood pressure in people with existing heart disease, one study showed.

And for obese people, shedding some weight appears to lower blood fats and other heart disease risks, the other study concluded.

Experts said the findings underscore the importance of detecting sleep apnea, which affects 18 million American adults, according to the National Sleep Foundation.

"Sleep apnea is quite common, but it often goes undiagnosed," said Dr. Daniel Gottlieb, a sleep specialist at Brigham and Women's Hospital in Boston, who led one of the studies.

"Treatment with CPAP may, in addition to improving sleep apnea symptoms, lower risk factors for heart attack and stroke," Gottlieb said.

For their study, Gottlieb and his team recruited 318 patients who had sleep apnea, plus heart disease or multiple risk factors for it, including high blood pressure, high cholesterol and diabetes.

The patients were randomly assigned to one of three treatments: education on good sleep habits, or either supplemental oxygen or a CPAP machine to be used at night.

CPAP is the treatment of choice for sleep apnea. The device comes with a mask that covers the mouth and nose, sending pressurized air into the throat. That keeps the throat structures from constricting and cutting off oxygen, but it can also be unpleasant.

"People who can't tolerate CPAP can get supplemental oxygen as a 'salvage' therapy," Gottlieb said. "That's easier to manage, because it's just a nasal cannula [flexible tube under the nose], and the air isn't pressurized."

But it's less effective for lowering blood pressure, Gottlieb's team found. Over 12 weeks, CPAP patients' blood pressure dipped by an average of 2 to 3 points compared with the other two groups.

That might not sound like a big difference. "But with high blood pressure, we say that every [point] matters," said Dr. Sripal Bangalore, a cardiologist at NYU Langone Medical Center in New York City.

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