There has been much research and debate over the last few decades into the relationship between sleep apnea and cardiovascular disease. This association was first observed in 1977 (1) and since then many studies have demonstrated a strong connection between obstructive sleep apnea or sleep disordered breathing and a myriad of cardiovascular consequences that include high blood pressure, stroke, cardiac arrhythmias, coronary artery disease and congestive heart failure.

In fact at least half of the 5 million U.S. heart failure patients have obstructive sleep apnea. (2)

The research supports a clear bidirectional relationship between sleep apnea and both cardiac and vascular disease. This means that sleep apnea has been shown to be an independent risk factor for the development of a variety of forms of cardiac and vascular disease. At the same time, some forms of heart and vascular disease, most notably heart failure and stroke, can in turn cause sleep apnea. "In some patients, it really becomes almost a chicken and egg thing in trying to figure out which came first." (3)

Regardless of their origin the link between sleep apnea and cardiovascular disease is now well established. Unfortunately, for a variety of reasons, “this link” has not been well accepted by the typical Cardiology practice. It has been reported that more than 35% of patients who present to a Cardiologist have sleep apnea, yet less than 5% are being diagnosed and referred for treatment. This is a particular acute problem in the state of Florida due to the large number of aging baby boomers that are choosing to retire here.

Sleep Management Centers recognizes this growing problem and has developed a program that works closely with Cardiology practices to successfully screen, diagnose and treat sleep disorders with related cardiovascular diseases. This process begins in the Cardiology office where patients can be screened using specific questionnaires, and if required, wear a small electronic screener device to bed at night. This screening unit measures a number of cardio-pulmonary parameters including the ability to record a 24 hour EKG holter study.

Patients testing positive for a potential sleep disorder will then be referred for a full polysomnograph (PSG) test that measures sleep efficiency and additional cardio-pulmonary function. The results of this test will indicate the type and severity of the sleep disorder and the recommended treatment. Fortunately the treatment for obstructive sleep apnea, by far the most common sleep disorder, is very effective. Patients regularly using a prescribed PAP device can essentially cure their sleep apnea. Less severe cases and chronic snoring can also be treated with oral appliances, both of which are available from Apnea Management Services.


The Cardio-Sleep Link by the numbers:

A great deal of research surrounding the link between sleep apnea and cardiovascular disease has revealed the following:

Most recently the Heart Failure Society of America (HFSA) 2006 Comprehensive Heart Failure Practice Guidelines states that Sleep Disordered Breathing (SDB) is a condition that puts heart failure patients at risk. This report concludes that SDB is a symptom of heart failure and should be considered in the diagnosis of all heart failure patients.

The Sleep Heart Health Study implemented by the National Heart, Lung, and Blood Institute has also determined that SDB is associated with numerous cardiovascular risk factors and the impairment of health-related quality of life.

There is now overwhelming evidence that supports the link between Sleep Apnea or Sleep Disordered Breathing and Cardiovascular disease. Sleep Management Centers is dedicated to increasing the awareness of the Cardio-Sleep link and improving the quality of life for patients that suffer from sleep disorders.

1. Tilkian, AG, Guilleminault C, Schroeder JS, Lehrman KL, Simmons FB, Dement WC. Sleep-induced apnea syndrome: prevalence of cardiac arrhythmias and their reversal after tracheostomy. Am J Med 1977; 63(3): 348-58.

2. Grandi, E Executive Director, American Sleep Apnea Association

3. Abraham, W Professor of internal medicine; director, Division of Cardiovascular Medicine; deputy director, Davis Heart & Lung Research Institute, The Ohio State University.

To search and review the hundreds of peer reviewed papers detailing the Cardio-Sleep link go to www.pubmed.com and input cardiovascular sleep apnea in the search field.