Sleep apnea is linked to atrial fibrillation

As time goes on and more research is completed, we continue to find connections with various health conditions and sleep apnea. We, as dental sleep medicine specialists (or soon to be), need to continue to advance our knowledge on these connections to better improve our patients’ health and well-being.

A recent study published in HeartRhythm looked at poor sleep quality as a major risk factor for atrial fibrillation. Researchers of this study even found a link independent of sleep apnea. Atrial fibrillation (AF) is an irregular, rapid heart rate that might cause a variety of symptoms such as heart palpitations, fatigue and shortness of breath. AF can significantly reduce a person’s quality of life. It also is linked with stroke, dementia, heart attack, kidney disease and even death.

Sleep apnea is a risk factor

Obstructive sleep apnea is known as a risk factor for AF. However, the mechanism remains unclear. Episodes of abnormal breathing and apnea may cause cardiopulmonary stress, induce inflammation and contribute to cardiovascular disease. OSA also results in poor quality sleep. When a person suffers from poor quality sleep, they can experience altered sleep duration, efficiency and architecture. These all link to cardiovascular diseases.

Researchers looked at four different studies to determine if poor sleep was a risk factor for AF. They found that a subset of these individuals who had undergone formal sleep studies experienced less REM sleep. This predicted future AF. Through further outreach, researchers found that sleep quality is extremely important to cardiovascular health, specifically to AF.  Sleep disruption was consistently an important risk factor. The underlying mechanisms are still unknown, but this study is a good way to think about sleep and AF.

OSA is prevalent among acute coronary syndrome patients

A patient admitted to the hospital for acute coronary syndrome is likely to also have obstructive sleep apnea (OSA). This was seen in findings presented at the Annual Meeting of the Associated Professional Sleep Societies. Understanding the effects of OSA on cardiovascular outcomes in acute coronary syndrome is important for risk assessments. It is also important for therapeutic recommendations in those affected.

What is the connection?

Over a period of about seven months, researchers completed a prospective observational study of 21 patients. These patients were over the age of 18 and were admitted to the hospital for acute coronary syndrome. They also had coronary revascularization during admission and underwent inpatient overnight sleep studies.

Of those who participated, 13 had adequate sleep data and OSA was discovered in more than half of the patients. The mean apnea-hypopnea index of the group was 27.1 events per hour compared to 5.6 events per hour in those without OSA. Researchers discovered heart failure diagnosis and cardiogenic shock during hospitalization are more likely in those without OSA compared to those with.

The researchers found a high rate of OSA among patients admitted to the hospital with acute coronary syndrome. But the sample size was not large enough to make any conclusions regarding primary endpoints. The next steps would be a larger sample size to find better outcomes.

However, this is still an area of our patients’ health we need to pay close attention to. As we find more research, we can better care for each individual patient.

Even minor sleep problems can raise a woman’s BP

Here we go again. Even the smallest sleep disturbance can increase a woman’s risk of high blood pressure. This isn’t good. Women who slept for the recommended duration also experienced this increase. The key is eliminating any sleep disturbances altogether.

We know that insufficient sleep increases blood pressure, which leads to a risk for heart-related conditions. However, researchers recently completed a study that assessed whether or not less serious sleep issues could also cause measurable cardiovascular effects. What they found was, yes, it can.

Women are affected the most

About one-third of people in the U.S. do not get enough sleep with women affected more than men. Women are often more likely to be carers for children and elderly relatives, which accounts for their lack of sleep. They can also experience shifts in hormones both monthly and across their lifespan.

Because of this, researchers looked to focus on women in this new study. What they found was particularly worrisome because sleep deprivation and milder sleep problems may have a disproportionate effect on cardiovascular health in women.

As dental sleep medicine specialists, we need to help care for not only all our patients, but women in particular due to their increased chances of a lack of consistent sleep.

Does treating sleep apnea improve diabetes management?

Managing diabetes requires a “day-in, day-out” effort to control the factors that affect blood sugar levels. And what might make it even more difficult to manage symptoms is if you suffer from obstructive sleep apnea. A study conducted by a team of scientists, including two professors at the West Virginia University School of Medicine, is working as part of a multi-center project sponsored by the National Institutes of Health.

The team of researchers looked to assess what impact treating obstructive sleep apnea has on diabetes self-management. Let’s take a look at what impact treating OSA has on diabetes self-management for our patients.

What is the connection?

OSA is a common disease that is linked to a range of problems in patients with diabetes and those who do not suffer from this condition. From poor work performance to heart failure, sleep apnea is the reason behind many health conditions. It can even make patients with diabetes less sensitive to their insulin.

In a recent study, researchers split patients in half. One half used a CPAP machine to treat their sleep apnea, while the other half used a mock CPAP machine that looks and feels like a regular machine, but does not impart any of its benefits. Throughout the study patients also underwent periodic blood sugar checks.

While the study has not concluded yet, researchers are hopeful that treatment of sleep apnea will help improve diabetes self-management in their patients. If the study does show that using CPAP machines improves blood sugar control in patients with diabetes and sleep apnea, there will be no reason why we should not screen more of our patients with diabetes for OSA.

If a patient has been diagnosed with sleep apnea, physicians can persuade them to use CPAP machines regularly. This can work with oral appliances too. Patients with diabetes struggle so much with their sugar levels. This study can provide some relief knowing there is another option to help improve their health.

I know this study doesn’t focus on oral appliances. But should look to oral appliance therapy as a safe alternative to CPAP for our patients.