Sleep Apnea And Hypertension

Feb. 20, 2006
Sleep apnea is a disorder of breathing during sleep and is typically accompanied by loud snoring. Apnea during sleep consists of brief periods throughout the night in which breathing stops. People with sleep apnea do not get enough oxygen during sleep.

I wanted to write this article as an informational piece for all of us. My name is Joe Sollecito and I own a sleep disorder testing and treatment company called, United Sleep Diagnostics, Inc.(USD) located in South Florida. The main component of our business is to test for and treat sleep apnea, which is a growing problem in our society. Sleep Apnea has been widely researched over the last 5 years. This research has found apnea to be the underlying cause or contributor to many disease processes such as: cardiovascular disease, hypertension, diabetes, obesity, and depression, to name a few. The one I'd like to talk about is hypertension, but first let me define sleep apnea.

Sleep apnea is a disorder of breathing during sleep and is typically accompanied by loud snoring. Apnea during sleep consists of brief periods throughout the night in which breathing stops. People with sleep apnea do not get enough oxygen during sleep. There are two major types of sleep apnea, they are:

  • Obstructive Sleep Apnea - is the most common type of apnea and is due to an obstruction in the throat during sleep. Bed partners notice pauses approximately 10 to 60 seconds between loud snores. The narrowing of the upper airway can be a result of several factors including inherent physical characteristics, excess weight, and alcohol consumption before sleep.
  • Central Sleep Apnea - is caused by a delay in the signal from the brain to breathe. With both obstructive and central apnea, you must wake up briefly to breathe, sometimes hundreds of times during the night. Usually there is no memory of these brief awakenings. Central Sleep Apnea is less common.

Some common signs and symptoms of apnea may include: snoring, choking or coughing during sleep, restless sleep, excessive urination at night, daytime fatigue, inability to concentrate, and headaches (more common upon waking in the morning).

Recent research has estimated that as much as 10-percent of our population may have sleep apnea and over 90-percent of those afflicted are undiagnosed. It is certainly no secret that as a society we have seen our national weight average increase. Think about it, we can do almost anything right from our cars, except have a tasty gourmet meal, and that is debatable as apparently many Americans think a McDonald's value meal is the equivalent.

So exactly what happens in the body to cause hypertension when these periods of apnea occur? Many different events occur in the body during an apnea but the one event that triggers the rest is the obstruction itself. When the obstruction occurs, most notably you will see a dramatic drop in the oxygen saturation, hence triggering the heart to increase its rate to compensate for the low oxygen in the blood. It is not uncommon for the individual to start having PVCs

The important point I'm trying to make is that this is documented in many journals, in fact most recently in The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), which lists sleep apnea as the number one identifiable cause of hypertension to assess for.

I know there are members on your department as well as mine that are very familiar with sleep apnea as they have been diagnosed and are getting treatment at this time. Treatment basically consists of either CPAP (continuous positive airway pressure) or surgery as well as lifestyle changes. The results of treatment are dramatic, just ask any patient who has had it. Think about this; how many times have you responded to a call after midnight when the patient complained of shortness of breath, or "I felt my heart beating fast", yet the patient has no history of significance and their symptoms are usually subsided by the time we are there. This is the patient that may have had an apneic event that awoke them from their sleep. Haven't you heard somebody snoring on the recliner or in the dorm only to all of a sudden stop breathing and then you hear them choking and wake up, this is apnea.

We all know that nutrition and exercise alone is not enough to lose weight if the individual is too fatigued to want to exercise. It is my belief that there are many firefighters who have undiagnosed apnea. That being said, I don't want to see any of our brothers on anti-hypertensives in a couple of years if not sooner. I am not writing this to scare anybody, it's just something we really need to be aware of. It is unfortunate, but because of our job and the hours we keep, it is difficult at times to have good dietary habits. This is a subject in and of itself that I will hopefully discuss further in a future article.

If you are interested in being tested, you will need a prescription from your physician. Once the test is completed, your doctor will get the results back from your test and should review them with you. This test is usually fully covered by your insurance except for the usual co-pays, co-insurances or deductibles, if applicable.

In closing I would like to leave you with some other eye opening statistics related to sleep apnea. Remember this is a disease process that can affect all age groups from pediatrics to geriatrics.

By the way, did you know...

  • Hypertension: People with sleep apnea are 50-percent more likely to develop hypertension
  • Stroke: People with sleep apnea have a 20-percent greater likelihood to have a stroke
  • Diabetes: People with sleep apnea are three times more likely to develop diabetes
  • Automobile Accidents: People with sleep apnea are three times more likely to be in an automobile accident
  • Cardiac Disease/Right Heart Failure: People with sleep apnea are five times more likely to develop cardiac disease/right heart failure
  • Sexual Dysfunction: People with sleep apnea are more likely to experience sexual dysfunction due to decreased libido, irritability, and chronic tiredness

If you or a family member is in need of a study and you have any questions, please feel free to contact me. I am more than happy to discuss your questions and concerns with you. My office number is: (954) 442-8694 and my cellular phone number is: (954) 444-8861.

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