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Sleep apnea worsens heart disease, but often untreated

Health care professionals urge increased awareness of obstructive sleep apnea amongst humans with cardiovascular disease or risk elements including excessive blood pressure, according to a new clinical statement from the American Heart Association, published recently in Circulation, the Association’s flagship journal. It states that sleep apnea worsens heart disease.

Obstructive sleep apnea (OSA) happens in 40% to 80% of people with cardiovascular disease, but it is under-recognized and undertreated, according to the statement. OSA occurs when an upper airway obstruction causes repeated episodes of disrupted respiration during sleep. Symptoms encompass snoring, lapses in breathing, fragmented sleep, and daytime sleepiness. In general, approximately 34% of middle-elderly men and 17% of middle-aged women meet the criteria for OSA. It has been found that sleep apnea worsens heart disease.

“Obstructive sleep apnea can negatively affect patients’ health and increases the risk of cardiovascular events and death. This statement is to encourage increased awareness, screening and remedy as suitable for sleep apnea,” stated Chair of the scientific statement writing group Yerem Yeghiazarians, M.D., FAHA, professor of medication and the Leone-Perkins Family Endowed Chair in Cardiology on the University of California, San Francisco.

Risk elements for OSA include obesity, large neck circumference, craniofacial abnormalities, smoking, family records, and middle-of-the-night nasal congestion.

The suggestion is given by American Heart Association:

  1. Screening for OSA in patients with resistant or hard-to-govern high blood pressure, pulmonary hypertension, and atrial fibrillation that recurs despite treatment.
  2. Screening for OSA via a sleep study for some patients with heart failure, in particular, if sleep-disordered breathing or immoderate daytime sleepiness are suspected.
  3. Treating patients diagnosed with OSA with available therapies, potentially including lifestyle and behavior adjustments and weight loss.
  4. When possible, treating patients with severe OSA with a CPAP machine.
  5. Treating mild to moderate OSA instances with oral appliances that adjust the jaw and tongue placement during sleep to prevent obstructed respiration.
  6. Routine follow-up including overnight sleep testing to confirm if treatment is effective.

“Improvements in-home diagnostic tools and extra research on ways to identify cardiovascular risk in people with OSA are needed,” Yeghiazarians stated. “Still, the overall message is clear: we need to increase awareness about screening for and treating OSA, especially in patients with existing cardiovascular risk factors.

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