Loud snoring that keeps a partner awake at night is one of the most common reasons that people seek assistance from Sleep Health Group. Other common reasons include daytime sleepiness and tiredness, dissatisfaction about the quality of sleep overnight, or concern about the long-term health risks of sleep disorders.
However, sometimes people seek assistance because they have been in hospital for another reason and nurses or doctors have observed them to be breathing badly while asleep. Obstructive sleep apnea (OSA) increases the risk of heart attacks and contributes to the development of heart rhythm problems. In people who have had a heart attack it also increases the risk of complications. For this reason, many cardiologists are careful to make sure that patients who have had a heart attack are carefully assessed for the presence of OSA.
A recent article from some researchers in Singapore which was published in the Journal of Clinical Sleep Medicine highlights the connection between sleep apnea and heart attacks. In this study, 101 patients who had a serious heart attack, an ST-elevation myocardial infarction, had a simple sleep study during their initial hospital stay. Alarmingly, 46 of these patients had clear OSA, with more than 15 episodes of badly obstructed breathing per hour. Another 12 had central sleep apnea (CSA), a pattern of disordered breathing which is usually caused by heart damage and may not be of any harm. Of these 101 patients, a minority of 43 had no evidence of breathing abnormality while asleep.
The patients in this study went on to have another sleep study, six months after the heart attack. This second study showed an evolution in patterns of breathing abnormality which was very interesting:
- 21 of the patients with OSA in hospital did not have OSA at 6 months
- 10 of the patients with central sleep apnea (CSA) in hospital had OSA at 6 months, and the other two still had CSA
- 3 of the patients who did not have OSA in hospital did have it at 6 months.
This study suggests that OSA is very common amongst people who have had heart attacks. It also shows that people who are found to have OSA when they have a heart attack may not have it 6 months later. However, 38% of the patients involved in this study did have persistent OSA 6 months after the heart attack.
In these patients, treatment of OSA should be considered, particularly if they are experiencing disturbed sleep and/or daytime sleepiness or keeping their partners awake at night with their snoring.