Your sleep can greatly affect your heart's health, especially if you are always having trouble getting a good night in.
I'm not talking about insomnia (which is also a problem, but we'll cover that some other time) but rather about sleep apnoea, which is a sleep disorder characterised by abnormal pauses in breathing during sleep, commonly found in obese people.
Sleep apnoea can cause blood pressure to rise and is caused by abnormalities in the respiratory tract and sometimes in the brain's breathing centre.
Interestingly, it is not people with sleep apnoea that come to see the doctor _ usually it's someone who sleeps next to them, or more to the point, someone who cannot sleep next to them, due to heavy snoring or sudden pauses in breathing. It's usually the latter that makes them rush to see a doctor.
One of the signs of sleep apnoea is feeling tired during the day despite having had a long night's rest. If you feel sleepy for no reason, check with the person who sleeps next to you or your doctor, just to make sure.
In the long run, sleep apnoea can cause chronic oxygen shortage, and the body will release substances that trigger the nervous system and essentially tell the blood vessels to tighten up, causing high blood pressure.
Apart from that, sleep apnoea can damage the inner lining of blood vessel walls, interfering with the substance that causes the blood vessels to dilate, which in turn affects the blood pressure and heart function and leads to heart failure.
The heart can stop beating altogether if the person leaves the condition untreated long enough to develop a weakened heart muscle or heart failure.
Those with sleep apnoea have a greater chance of having high blood pressure, heart disease and a stroke.
Therefore, if sleep apnoea is the cause of your high blood pressure, treating it will help bring your blood pressure level back to normal _ or at least make it easier to control. In mild cases, losing weight can help a great deal, and it also lowers the chance of heart disease, high blood pressure, diabetes and high cholesterol. Changing sleeping positions can also make a difference.
Avoiding alcoholic drinks, sleeping pills and smoking are also very important to the treatment. If the condition doesn't improve, consult a doctor, because there are so many reasons why a person has sleep apnoea. It can be the brain or an obstruction in the respiratory tract.
To determine the real cause, careful examination is needed. It is best to start treatment early before sleep apnoea has permanently damaged your health. If you sleep next to someone who snores, listen to the sound of his or her snoring. Sometimes snoring becomes heavier after drinking alcohol or taking sleeping pills.
In obese people, sometimes the soft palate and soft fatty tissue behind your tongue relaxes down during sleeping in the supine (on your back) position and obstructs the respiratory tract. This is why for some people, sleeping on the side can get rid of the snoring completely.
In general, if there is obstruction in breathing momentarily, the person will gain consciousness and the soft palate will firm up, stopping the snoring. Some might wake up and fall back to sleep in a cycle, causing sleep deprivation.
That explains why they might feel sleepy during the day _ some even fall asleep while tying their shoelaces! They are also unable to focus because the body does not get enough rest.
This is where the vicious cycle begins. Once the body is not well-rested, the person cannot do activities well, and inactivity leads to weight gain. Weight gain leads to sleep apnoea and high blood pressure, which is worsened by the fact that when snoring, the obstruction causes the pressure in the chest to increase, which might cause an enlarged heart. An enlarged heart can lead to heart failure. See how scary it is?
A patient of mine was 56 years old. He was overweight and sometimes snored when he slept.
However, he came to see me because his blood pressure was found to be high.
After careful examination, I found that he had sleep apnoea, so I prescribed some medicine and told him to lose weight. After he had lost 6-7kg, his blood pressure was back to a healthy range, and his snoring stopped completely.
Ironically, it was his wife that started to lose sleep, because without the sound of his snoring, she would sometimes wake up in the middle of the night thinking he had snuck out.
Dr Nithi Mahanonda is a consultant cardiologist and interventionist, Perfect Heart Institute, Piyavate Hospital. Visit his website at www.drnithi.com
About the author
- Writer: Dr Nithi Mahanonda