Sleep apnea and coronary artery disease: what's the connection?

Coronary artery disease is a buildup of plaque in the arteries that supply blood to your heart. It’s the most common type of heart disease in the United States. Sleep apnea is a condition

where your breathing starts and stops repeatedly throughout the night. It’s associated with higher rates of many types of cardiovascular disease, including coronary artery disease.

Researchers estimate 24 million people in the United States have obstructive sleep apnea but haven’t been diagnosed. Without proper treatment, sleep apnea can cause a negative loop: The

sleep apnea worsens cardiovascular conditions that in turn worsen the sleep apnea. Read on to learn more about what’s known about the connection between sleep apnea and coronary artery

disease. What is sleep apnea? Sleep apnea is a common sleep disorder. It’s characterized by the repeated stopping of your breath while sleeping. Pauses in your breathing may occur hundreds

of times each night. The most common type of sleep apnea is called obstructive sleep apnea. It occurs when the muscles in your throat relax, and your tongue and soft palate block your throat

while sleeping. Researchers estimate obstructive sleep apnea affects roughly a quarter of people between ages 30 to 70 in the United States. Most of the research examining the connection

between sleep apnea and heart disease is on obstructive sleep apnea. Central sleep apnea is less common. It occurs when your brain doesn’t send signals to the muscles that control your

breathing while you’re sleeping. It’s been estimated to affect 0.9% of people. Some people also have mixed sleep apnea, or a combination of both types. Symptoms of sleep apnea Symptoms of

sleep apnea can include: * periods when you stop breathing while sleeping, as witnessed by another person * restless sleep with frequent wakefulness * excessive sleepiness during the day *

loud snoring, often with choking sounds or gasping * morning headaches * dry mouth upon waking * reduced mood or ability to focus Does sleep apnea lead to heart damage? Substantial research

suggests obstructive sleep apnea is associated with an increased risk of cardiovascular disease and cardiovascular death. Some research suggests the risk in people with obstructive sleep

apnea is double. Obstructive sleep apnea has been associated with many forms of cardiovascular disease, including: * high blood pressure * stroke * heart failure * coronary artery disease *

arterial fibrillation Stoppages in your breathing can lead to repetitive low oxygen levels in your blood, which may result in oxidative stress and inflammation throughout your body. Over

time, this stress and inflammation can contribute to the development of plaque buildup in the arteries of your heart, which can lead to a heart attack. Research from 2018 estimates that

obstructive sleep apnea affects 34% of men and 17% of women in the general population but 40% of men and 60% of women with cardiovascular disease. Sleep apnea may lead to the development of

coronary artery disease by contributing to calcium buildup and plaque instability in the arteries of your heart. In a 2019 study, researchers found evidence that the presence of plaque in

the arteries of the heart was significantly associated with the severity of sleep-disordered breathing in people with a low to medium risk of coronary artery disease. What happens if you

don’t treat sleep apnea? Untreated sleep apnea increases the risk of developing many types of cardiovascular disease, such as: * stroke * heart failure * heart attack The risk of

cardiovascular complications generally increases with the severity of sleep apnea. Sleep apnea can also raise the risk of developing other issues, such as: * metabolic syndrome * excessive

daytime sleepiness * increased risk of traffic accidents * increased risk of workplace errors Researchers have also found clear associations between obstructive sleep apnea and: * high blood

pressure * type 2 diabetes * depression * surgical complications * cancer * early death How to treat sleep apnea if you have cardiovascular risk Your doctor can help you build a treatment

plan for your sleep apnea. The treatment your doctor recommends depends on factors such as the underlying cause of your sleep apnea and your current lifestyle habits. Your doctor might

suggest: * WEIGHT MANAGEMENT: If you have overweight or obesity, your doctor may recommend losing weight. * CERTAIN LIFESTYLE HABITS: Your doctor may recommend certain lifestyle changes,

such as quitting smoking, limiting alcohol, or switching to sleeping on your side. * CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP): CPAP is often the first treatment for obstructive sleep

apnea. It involves wearing a face mask that delivers air with positive pressure to keep your airways open while you sleep. * BILEVEL AIRWAY PRESSURE (BIPAP): BiPAP is sometimes used as an

alternative to CPAP. BiPAP machines deliver air at two pressure levels in response to your breathing to help support your airways. * SURGERY: Surgery is usually only recommended when less

invasive treatments aren’t effective. Surgery involves changing the part of your body that’s causing the obstruction. FAQs Here are some frequently asked questions people have about the

connection between sleep apnea and coronary artery disease. CAN SLEEP APNEA CAUSE HEART DAMAGE? Frequent breathing pauses while sleeping can cause stress that promotes inflammation. This

inflammation can contribute to the development of heart damage and disease. DOES SLEEP APNEA CAUSE PLAQUE IN ARTERIES? Plaque is the buildup of cholesterol, fat, and other substances inside

your arteries. Research suggests that people with sleep apnea have an increased risk of plaque buildup and instability that contributes to the development of heart attack or stroke. CAN

SLEEP APNEA WORSEN CARDIAC PROBLEMS? Yes. Sleep apnea can worsen heart problems by disrupting your sleep and causing low oxygen levels in your tissues while you sleep. Worsening heart

problems may also contribute to the worsening of your sleep apnea. Takeaway A substantial amount of research shows that people with sleep apnea have an increased risk of cardiovascular

disease. People with sleep apnea also tend to have poorer outcomes with cardiovascular disease than people in the general population. Seeking treatment for sleep apnea may help you lower

your risk of developing cardiovascular disease and other complications. Your doctor can help you develop a plan to manage your sleep apnea. Your plan may include a combination of lifestyle

changes and positive airway pressure therapy, depending on the underlying cause.