Can Sleep Apnea Treatment Also Improve Heart Health?

Reviewed by Anh – Licensed Practical Nurse

Does sleep apnea increase the risk of cardiovascular disease?

Current research shows that sleep apnea is correlated with several serious cardiovascular diseases. Not only that, but the evidence for Obstructive Sleep Apnea (OSA) increasing the risk of heart disease is very strong. 

According to a study done by Gunta et al (2022), OSA sets off a chain of events in the body that tend to harm the cardiovascular system more or less directly. 

Diminished blood oxygen and too much carbon dioxide in the bloodstream – both of which are related to OSA – trigger responses in your body that can result in high blood pressure and other blood-related stress. In addition, OSA is related to higher levels of hormones that help regulate salt and water in the body – two substances that significantly affect blood pressure (Gunta et al, 2022). 

Chronically low oxygen levels in the bloodstream coupled with sleep deprivation activate inflammatory pathways that contribute to systemic inflammation. And when you’re in a chronically inflamed state while experiencing OSA-related endocrine stress and other issues, your body becomes prone to producing blood clots (Gunta et al, 2022). 

Given these facts, even if you’re a layperson with an only cursory knowledge of human physiology, you can reason that sleep apnea is potentially detrimental to heart health. 

What is the main cardiovascular symptom associated with sleep apnea?

Several types of arrhythmias potentially have the highest prevalence in people who suffer from Obstructive Sleep Apnea, depending on the research study. Please see the table below for the cardiovascular disorders and symptoms that occur in OSA patients most frequently (source). 

OSA-Related Cardiovascular Disorder	Rate of Occurrence in OSA Patients
High Blood Pressure	50%
Heart Failure	49% in men; 36% in women
Nocturnal Arrhythmias	Up to 50%
Ventricular Arrhythmias	Up to 66%
Atrial Fibrillation	21% – 74% (depending on study)
Coronary Artery Disease	38% – 65% (depending on study)

Does obstructive sleep apnea treatment reduce cardiovascular risk?

CPAP, continuous positive airway pressure, is the staple therapy for OSA. CPAP therapy greatly reduces the harm of OSA on the body, diminishing hypoxia (low blood oxygen) and hypercapnia (excess carbon dioxide in the bloodstream) – the two main adverse effects of Obstructive Sleep Apnea on the cardiovascular system (Gunta et al, 2022). 

By diminishing these risk factors of OSA, CPAP reduces the risks of OSA-related cardiovascular issues. 

Does CPAP improve heart function?

A 2016 study of the effects of CPAP on cardiovascular events revealed that CPAP therapy does indeed reduce cardiovascular risk but only in patients with high therapy adherence (source). More specifically, those heart disease patients with OSA who adhered to CPAP therapy for at least four hours per night showed a significant reduction in cardiovascular events compared to the group who adhered to using their CPAP less consistently.

Does sleep apnea affect blood pressure?

Sleep apnea does indeed affect blood pressure. Episodes of hypoxia (low blood oxygen) result in higher blood pressure and put more stress on the heart. Patients with untreated Obstructive Sleep Apnea are at 2-3 times the risk of developing high blood pressure (Gunta, 2022). 

Does CPAP therapy lower blood pressure?

Research studies show that treating sleep apnea with CPAP therapy helps lower blood pressure. The more severe your case of OSA, the more CPAP will lower OSA-related high blood pressure, especially if you are highly compliant with your CPAP therapy (Gunta, 2022). 

How quickly does CPAP improve blood pressure?

A study done by Javaheri et al (2020) revealed that morning systolic blood pressure was reduced by 2.4 mmHg after two months of consistent CPAP therapy in OSA patients. 

Can high blood pressure from sleep apnea be reversed?

Yes, high blood pressure resulting from sleep apnea can be reversed by using CPAP to treat the sleep disorder (Javaheri et al, 2020). If your high blood pressure does not significantly improve as a result of at least two months of CPAP therapy, this means that your hypertension has caused other than sleep apnea, and you should address those factors.

Can sleep apnea cause clogged arteries?

Sleep apnea has been shown to cause direct harm to the inner lining of blood vessels and to other aspects of vascular health. As a result, OSA patients often suffer from vascular disorders that involve blood clots, blood viscosity issues (thicker blood), and inflammation (Peracaula et al, 2022). 

Can CPAP reverse the damage done to blood vessels?

OSA patients tend to have lower levels of endothelial progenitor cells (EPCs) in the bloodstream. EPCs are various types of cells that are involved in the regeneration and repair of the inner lining of blood vessels. 

CPAP therapy has been shown to increase the numbers of these highly valuable cells, thus helping repair blood vessels and improve vascular health. Therefore, yes, CPAP therapy helps reverse the damage done by sleep apnea to blood vessels (Peracaula et al, 2022). 

Can CPAP improve circulation, lower triglycerides, or lower cholesterol?

Because CPAP improves overall vascular health, improved circulation is to be expected as a direct effect of having healthier blood vessels. 

A study by Simon et al (2019) states that “CPAP therapy has a rapid and long-lasting beneficial effect on the lipid profile of patients with severe OSA,” (p. 1). Your lipid profile is blood work that includes four types of cholesterol and the triglyceride level. 

However, research generally points to the lack of definitive evidence that CPAP lowers triglycerides or cholesterol. So, it all depends on the study you read. That said, if you have severe OSA and OSA-related high levels of triglycerides or cholesterol, and at the same time you adhere well to your CPAP therapy, you can reasonably expect your overall lipid profile to improve.

Can sleep apnea cause irregular heart rhythm?

Up to half of all OSA patients experience nocturnal arrhythmias. A sleep apnea diagnosis increases the risk of night arrhythmias 2-4 fold. Breathing abnormalities during sleep tend to trigger various arrhythmias, including bradyarrhythmias (abnormally slow heart rate) and tachyarrhythmias (abnormally fast heart rate), (Gunta et al, 2022). 

Can sleep apnea cause palpitations during the day?

Sleep apnea events can trigger arrhythmias that result from stimulation or disruption in the work of parasympathetic and sympathetic systems in your body. This means that two categories of arrhythmias occur – those that are associated with rest and those related to stressful events (known as fight-or-flight). The effects of these latter apnea events that stimulate the sympathetic system continue into the day, increasing the risk of daytime arrhythmias (DiFusco et al, 2020). 

Does CPAP help heart rate?

A number of studies in which researchers were measuring the effect of CPAP therapy on various types of arrhythmia came to conclusions that can be summarized as follows. 

Consistent CPAP therapy:

• Never increases the occurrence or severity of arrhythmias
• May have no effect on certain arrhythmias
• Can often improve arrhythmias
• A lot less commonly, CPAP can lead to a total reversal of OSA-induced arrhythmias (DiFusco et al, 2020).

In other words, using CPAP improves your chances of correcting arrhythmia and poses no risk of making arrhythmia worse. 

Can CPAP reverse bradycardia?

At least two research studies have shown a reduction in bradycardia episodes in OSA patients who use CPAP as sleep apnea treatment (source).

Can sleep apnea lower ejection fraction?

Studies show that OSA is indeed associated with reduced ejection fraction (source). 

Can CPAP improve ejection fraction?

In one study, 30 days of consistent CPAP use resulted in a 9% increase in ejection fraction (Gunta et al, 2022). 

Can a cardiologist prescribe a CPAP machine?

Any licensed physician can prescribe CPAP. However, a sleep specialist can assess your sleep more thoroughly by administering a detailed sleep study. 

Do cardiologists treat sleep apnea?

The staple treatment for sleep apnea is CPAP therapy, and a cardiologist can prescribe it. However, if you suspect that you have sleep apnea, first, you can read this article to help you either confirm or dispel your suspicions. 

And second, you can and probably should speak with a sleep specialist to obtain a detailed diagnosis. A sleep specialist can prescribe CPAP for you, observe your CPAP therapy, and make modifications in your treatment, even virtually. 

At Respshop, we offer a simple, home-based sleep test that can reveal if you have sleep apnea. You can speak with one of our sleep specialists, get a diagnosis, and receive a prescription to treat your specific case of sleep apnea. 

And should you need to purchase a CPAP machine, Respshop is your trusted online source for top-rated CPAP equipment at a discount. We are here to help. 

References

Di Fusco, S. A., Pignalberi, C., Santini, L,. Colivicchi, F., & Santini, M. (2020). Arrhythmias and sleep apnea: Physiopathologic link and clinical implications. Journal of Interventional Cardiac Electrophysiology, 57(3), 387-397.

Gunta, S. P., Jakulla, R. S., Ubaid, A., Mohamed, K., Bhat, A., López-Candales, A., & Norgard, N. (2022). Obstructive sleep apnea and cardiovascular diseases: Sad realities and untold truths regarding care of patients in 2022. Cardiovascular Therapeutics. 8/11/2022, 1-10. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/36017216/ 

Javaheri, S., Gottlieb, D. J., & Quan, S. F. (2020). Effects of continuous positive airway pressure on blood pressure in obstructive sleep apnea patients: The Apnea Positive Pressure Long-term Efficacy Study (APPLES). Journal of Sleep Research, 29(2), 1-8.

Mokhlesi, B. & Ayas, N. T. (2016). Cardiovascular events in obstructive sleep apnea — can CPAP therapy save lives? New England Journal of Medicine, 375, 994-996. Retrieved from: https://www.nejm.org/doi/full/10.1056/NEJMe1609704 

Peracaula, M., Torres, D., Poyatos, P., Luque, N., Rojas, E., Obrador, A., Orriols, R., & Tura-Ceide, O. (2022). Endothelial dysfunction and cardiovascular risk in obstructive sleep apnea: A review article. Life, 12(4), 1-15. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025914/ 

Simon, B., Gabor, B., Barta, I., Paska, C., Boszormenyi, N. G., Vizi, E., & Antus, B. (2020). Effect of 5-year continuous positive airway pressure treatment on the lipid profile of patients with obstructive sleep apnea: A pilot study. Journal of Sleep Research, 29(2), 1-9. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/31131516/