Sleep apnea is a common condition marked by repeated breathing interruptions during sleep, depriving the body of oxygen and disrupting sleep quality. Many wonder if it causes daytime heart palpitations. This article explores the connection.
The Link Between Sleep Apnea and Heart Palpitations
Sleep apnea can contribute to heart palpitations, including daytime ones. Nocturnal apneic episodes stress the body, with residual effects manifesting during waking hours. A study, for instance, found CPAP treatment lowered resting heart rate day and night. Untreated sleep apnea increases abnormal heart rhythm (arrhythmia) risk.
Physiological Impact on the Heart
Sleep apnea causes heart palpitations through several physiological responses. During an apneic event, blood oxygen levels drop significantly (hypoxia). This intermittent hypoxia stresses the heart, as it must work harder to supply oxygen to the body and can cause oxidative stress.
Sleep apnea also triggers repeated activation of the sympathetic nervous system (fight-or-flight response). This leads to increased heart rate and blood pressure surges during sleep, and this heightened sympathetic tone can carry over into waking hours. This chronic overactivity can promote arrhythmias, including palpitations.
Intrathoracic pressure changes also play a role. When individuals with obstructive sleep apnea attempt to breathe against a closed airway, they create strong negative pressure within the chest cavity. These repetitive pressure changes can affect heart function and electrical stability, potentially causing irregular heartbeats. Over time, these mechanical stresses can damage the heart’s structure.
Chronic sleep apnea can induce systemic inflammation. These processes contribute to endothelial dysfunction, where the lining of blood vessels is impaired. This systemic impact can further compromise cardiovascular health and contribute to cardiac arrhythmias.
Associated Cardiac Risks
Beyond palpitations, sleep apnea is linked to several other common heart conditions. Atrial fibrillation (AFib), an irregular and often rapid heartbeat, has a strong connection with sleep apnea. Individuals with sleep apnea are two to four times more likely to develop AFib.
Sleep apnea significantly contributes to hypertension, or high blood pressure. Recurrent episodes of oxygen deprivation and sympathetic activation can lead to persistent elevation of blood pressure, even during the day. Many patients with hypertension, particularly those with resistant hypertension, also have underlying sleep apnea.
The condition also increases the risk of heart failure, where the heart cannot pump enough blood to meet the body’s needs. Sleep apnea can increase the risk of heart failure by 140%. The repeated stress and physiological changes can lead to structural and functional changes in the heart, contributing to its weakening.
Sleep apnea can exacerbate coronary artery disease, which involves the narrowing of arteries that supply blood to the heart. This can accelerate the progression of atherosclerosis, the buildup of plaque in the arteries, increasing the risk of adverse cardiovascular events.
Steps for Diagnosis and Management
Individuals experiencing persistent heart palpitations or suspecting sleep apnea should seek medical evaluation. A healthcare provider can assess symptoms and recommend appropriate diagnostic tests.
Sleep apnea is typically diagnosed through a sleep study, known as polysomnography, which monitors breathing patterns and heart rate. Heart palpitations can be evaluated using an electrocardiogram (ECG) or a Holter monitor, which records heart activity over an extended period.
Treating sleep apnea can effectively reduce or eliminate associated heart palpitations and other cardiac risks. Continuous Positive Airway Pressure (CPAP) therapy is a common and effective treatment that delivers a steady stream of air to keep the airway open during sleep. CPAP can improve heart shape and size and lower blood pressure and heart rate.
Lifestyle changes are important. These include weight loss, regular exercise, avoiding alcohol and sedatives, and side sleeping. Dentist-fitted oral appliances can also help keep the airway open for some. In some cases, surgical options may be considered.
Managing sleep apnea often requires a collaborative approach involving sleep specialists, cardiologists, and other healthcare professionals. Addressing the underlying sleep disorder can lead to significant improvements in cardiovascular health and overall well-being.