Sleep Apnea Research

Possible Consequences of Untreated Sleep Apnea

Author’s Note: This article was reviewed by Dr. Ritwick Agrawal, Board Certified in Sleep Medicine, Pulmonary Medicine, and Critical Care. His views are solely his own and not endorsed by his employer.

How Serious is Sleep Apnea?

To start, let’s recap what Sleep Apnea is. Obstructive Sleep Apnea refers is a condition in which your airway completely or partially closes during sleep, thus depriving the individual of oxygen. Sleep Apnea is most commonly treated with CPAP therapy, which delivers pressurized air to help keep passageways open.

The Effects of Sleep Apnea on Your Health

When Sleep Apnea isn’t treated, an individual may experience some of the following health consequences:

  • High Blood Pressure
  • Cardiac Conditions
  • Heart Attack
  • Irregular Heartbeat
  • Stroke
  • Alzheimer’s Disease
  • Nocturnal Sleep Debt
  • Daytime Sleepiness
  • Morning Headaches

High Blood Pressure is a consequence of untreated Sleep Apnea. Showing a woman getting her blood pressure checked.

1. High Blood Pressure

Untreated Sleep Apnea over time may increase blood pressure and is one of the several causes leading to or worsening the blood pressure. While blood pressure medication is a typical course of treatment, it is also important to understand and treat the root cause. If a patient with Sleep Apnea goes undiagnosed or opts not to use their CPAP, they may risk bringing an increasing amount of blood pressure medicine over time. Getting tested for Sleep Apnea is a great way to ensure you are treating your high blood pressure comprehensively and reduce your risk of having other related issues. Which brings us to our next topic:

2. Cardiac Conditions

There are also a number of cardiac conditions that untreated Sleep Apnea can worsen.

Heart Arrhythmia or an irregular heartbeat. For individuals with untreated Sleep Apnea, a cardiac arrhythmia may occur. While the exact cause isn’t certain, studies suggest the change in pressure to the chest cavity may impact the heart1.

Atrial Fibrillation or “A-Fib”. The heart has four chambers and a normal electric current pathway. This current keeps the heart beating in a rhythmic fashion. Atrial Fibrillation is another way of saying your heartbeat becomes irregular. With Atrial Fibrillation, instead of the heart passing blood from one chamber to another, blood pools in areas it shouldn’t and causes blood clots. If the clots break down, they can travel through the blood vessels and go places it shouldn’t like the brain, causing a stroke.

Myocardial Infarctions or “Heart Attacks”. Over time, the increased load to the heart from high blood pressure can also increase the risk of having a heart attack. Staying on top of high blood pressure as suggested above, is one way to help prevent major heart issues.

Dr. Agrawal mentioned NFL star, Reggie White, who passed away in 2004 likely had Sleep Apnea. While his cause of death was not listed as Sleep Apnea specifically, it was listed as a heart condition. His family has since created the Reggie White Foundation, which provides research and awareness for Sleep Apnea.

3. Alzheimer’s Disease

Patients with Sleep Apnea are at higher risk of developing Alzheimer’s Disease. According to an article published in Science News on July 21, 2018, sleep helps relieve the brain from a buildup of A-beta deposits. A-beta deposits, the article writes, have been linked to Alzheimer’s Disease. Sleep is a restorative function of the body where waste that builds up during the day is then flushed out. If you’re not sleeping properly, you’re not giving your body enough time to do what it needs to do to create a healthy environment for your brain2.

Over time, you may develop a large amount of A-beta deposits that can eventually contribute to Alzheimer’s Disease. If you’re not treating Sleep Apnea, you’re not getting a good night’s sleep, as you’re constantly having to wake up to breathe. The Alzheimer’s risk for patients with Sleep Apnea is a fairly recent discovery and is yet another reason to make sure that you’re getting the treatment you need 2.

Nocturnal Sleep Debt can cause many cognitive issues down the road. Picture of a woman sleeping.

4. Nocturnal Sleep Debt

Dr. Agrawal also mentioned how poor sleep contributes to something called “nocturnal sleep debt”. If someone is not getting rest (he recommends between 7-8 hours a night), one can develop a “debt” to the body which needs to be recovered. So, if you have a busy week, and only get 5 or 6 hours of sleep each night, you may find yourself sleeping 8-10 hours over the weekend to make up for the lack of sleep. If someone is not sleeping well for a prolonged duration such as months, this begins to be considered a chronic sleep debt.

Nocturnal sleep debt is common among those with untreated Sleep Apnea because it’s difficult to get that sound, quality sleep needed to truly be rested. Treating Sleep Apnea can help improve things like daytime sleepiness, sudden drowsiness, and generally increase energy levels.

5. Day Time Sleepiness

Of course, there’s also daytime sleepiness, which can cause a lot of other issues, like sleep-related driving accidents. Not only does someone low on sleep, risk falling asleep behind the wheel, they may also suffer from delayed reaction times. This “impairment with executive functions” refers to the problem of having a hard time concentrating and issues such as short-term memory. Remember, when you’re tired and you get behind the wheel, you aren’t putting just yourself at risk, but also those in the car with you and on the road.

6. Morning Headaches

Many with untreated Sleep Apnea are likely to experience headaches when they wake up in the morning. Dr. Agrawal mentioned these headaches occur due to the lower oxygen levels which untreated Sleep Apnea can create. In turn, it causes blood vessels to widen, which is what can cause these headaches. As you breathe more normally, during your wake state, the headache will likely begin to lift.

Dr. Agrawal’s Advice on How to Make the Best of Your Sleep Apnea Treatment

Dr. Agrawal offers the following advice about treating Sleep Apnea:

“With a CPAP, you have to have the mindset to invest in your health, with the hope you won’t have as many consequences down the road. If you have these symptoms, a CPAP can help prevent them from worsening.” Dr. Agrawal says. “What I tell my patients is: once they start using CPAP, they must prepare and know the first three weeks will be difficult.” Dr. Agrawal suggests easing the transition period by wearing your mask while watching TV to help adjust to the feeling of having something on your face.

Dr. Agrawal also notes it’s also very important to stay in touch with your provider, whether it’s your equipment provider or doctor. If you are having pain or discomfort with the therapy, it’s best to get answers to problems right away in order to get over the first three-week hump and adapt to successful CPAP therapy.

About Dr. Agrawal

Dr. Agrawal is board certified for Sleep Medicine, Pulmonary Medicine, Critical care and Internal medicine and has dual appointment at Baylor College of Medicine and the Michael E. DeBakey Veterans Affairs Medical Center. His thoughts and advice above are solely his own and not endorsed by his employer.

You may also follow him on Twitter under the handle @md_ritwick.

References:

1. Ahmad Salah Hersi. Obstructive Sleep Apnea and Cardiac Arrhythmias. Published in the medical journal “Annals of Thoracic Medicine”, January 2010. Accessed on August 24, 2018.

2. Biel, Laura. The Brain May Clean Out Alzheimer’s Plaques During Sleep. Published in the magazine Science News on July 21, 2018. Accessed August 22, 2018.

National Highway Transportation Saftey Administration “Drowsy Driving”. Published on the NHTSA official website. Accessed on August 23, 2018.

David Repasky has been using CPAP treatment since 2017 and has first-hand experience with what it’s like to live with Sleep Apnea. He brings the patient’s perspective to the CPAP.com blog and has received formal training in CPAP machines, masks, and equipment.

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