Sudden Death in Sleep:Sleep Apnea

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Sudden Death in Sleep Apnea

People with obstructive sleep apnea have a peak in sudden death from cardiac causes during the sleeping hours. OSA is associated with neurohormonal and electrophysiological abnormalities that may increase the risk of sudden death from cardiac causes, especially during sleep. The sleep disorder can lead to atrial fibrillation and flutter.

In a study of patients who died suddenly who had had recent sleep studies performed, it was shown that almost half of the patients with sleep apnea died between the hours of midnight to 6 a.m., compared with 21% without sleep apnea. It is possible that these individuals died suddenly during periods of apnea.

Obstructive Sleep Apnea

There are two types of sleep apnea and two basic types of arrhythmias. The most common type of sleep apnea is obstructive sleep apnea (OSA). This was associated with the more deadly form of arrhythmia affecting the lower chambers of the heart.

Obstructive sleep apnea occurs when the airways constrict due to the relaxation of sleep. This is what causes the snoring sound. OSA can be treated easily with a CPAP machine or by Surgery. You may want to monitor your nighttime oxygen level even after you get your CPAP to make sure it is above 90 percent.

Central Sleep Apnea

Central Sleep Apnea (CSA) occurs when the sleeper stops breathing the brain forgets to send the signal. CSA can be treated with a Bi-PAP or APAP (Auto-titration CPAP) which keeps the breathing constant.

Sleep apnea has been linked to many chronic medical conditions, and even sudden death:

Hypertension and Coronary Heart disease (CAD

The risk for cardiovascular disease increases due to several mechanisms. It is estimated that 50-70% of people with sleep apnea have hypertension, or high blood pressure. This increases the risk for heart attack, stroke, and other health problems. In people with hard-to-control hypertension, it may be that sleep apnea is contributing. Sleep apnea can lead to activation of the sympathetic nervous system. All of these can cause problems with blood vessels and lead to major problems like a heart attack.

Chronic Heart Failure

When apneic events occur, the decreased levels of oxygen can cause blood vessels in the lungs to constrict. This increases the blood pressure in these vessels and over time may lead to chronic right-sided heart failure. High blood pressure is a major contributor to left-sided heart failure. Some studies have shown that as many as 37% of people with heart failure may have sleep apnea.

Stroke

During apnea, blood vessels within the brain dilate when the oxygen levels fall. Moreover, individuals with sleep apnea have higher levels of blood factors that make them more susceptible to clots that may lead to stroke. Approximately 40-60% of people with stroke are found to have obstructive sleep apnea.

Sleep apnea has the potential to kill you if you don\’t get help. If your partner or you snore, see your doctor.