Cardiac Sleep Medicine

What does sleep have to do with the heart?

Sleep medicine is a relatively new field that has gained increasing recognition for its impact on heart health. As we learn more, we are finding that problems with sleep, including sleep apnea, can have potentially severe effects on the cardiovascular system including possible increased risk of hypertension, arrhythmia, including atrial fibrillation, heart disease and stroke.

Sleep apnea carries additional relevant health risks including type 2 diabetes, metabolic syndrome, complications with medications and surgery, liver problems. Patients may notice subjective complaints such as troubles staying asleep, awakening with a morning headache, dry mouth, unrefreshed with daytime sleepiness, difficulties concentrating, with short term memory, irritability and possibly sleep-deprived partners.

What is sleep apnea?

Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts with potentially sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system.

The main types of sleep apnea are:

  • Obstructive sleep apnea, the more common form that occurs when throat muscles relax
  • Central sleep apnea, which occurs when the brain doesn't send proper signals to the muscles that control breathing
  • Complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, which occurs when someone has both obstructive sleep apnea and central sleep apnea

How is sleep apnea diagnosed?

Referral to a sleep specialist who will review the signs, symptoms, and sleep history and determine need for further evaluation. Testing includes:

  • Nocturnal polysomnography. Performed in a sleep lab, the patient is connected to equipment that monitors the heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels while sleeping.
  • Home sleep tests. This is a simplified test to be used at home to diagnose sleep apnea. These tests usually measure the heart rate, blood oxygen level, airflow and breathing patterns.

How is sleep apnea treated?

The most widely accepted treatment is the use of Continuous Positive Airway Pressure (CPAP), delivered through a mask worn when sleeping. The mask provides an “air splint” to keep the breathing passages open throughout all stages of sleep. Modern CPAP units are quiet and portable, and new technologies have produced a variety of the most comfortable and least intrusive masks to date.

For those patients who cannot tolerate CPAP, second line treatments are available, including dental appliances and surgery.

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International Heart Institute - Montana Cardiology

International Heart Institute

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We're part of the International Heart Institute of Montana, a member of Providence Medical Group