If there is one piece of wisdom that doctors have gained over the past 20 years, it is: that the slower the heart beats, the better. Whenever someone has a heart attack or is diagnosed with coronary heart disease, then a good doctor puts the patient on medications that lower the heart rate (usually drugs that are classified as high blood pressure medications).
Conditions that disrupt the sleep such as sleep apnea or insomnia can lead to arousals (many of which are not remembered) and this in turn leads to over-stimulation which increases the firing of the sympathetic nervous system (i.e. a rush of adrenalin). This is all a fancy way to say: when you don’t have good sleep, your heart is not resting as it should. You can have an increase in your blood pressure and an increase in your heart rate that over many years can increase your risk for high blood pressure, heart disease, congestive heart failure, stroke and cardiac arrhythmias such as atrial fibrillation or ventricular tachycardia (as well as many other conditions such as diabetes, obesity, dementia and impotence).
If you treat sleep disorders such as sleep apnea, it can dramatically benefit your heart. For example, I saw a patient this week, Richard, who had an initial, diagnostic sleep study that found significant sleep apnea and showed that his maximum heart rate while asleep was 122 bpm (beats per minute) with a mean pulse rate of 80. This was much higher than expected for this extremely fit, 69 year old man who has a resting heart rate in the daytime of 65 bpm. When he returned to the sleep lab and was started on CPAP (Continuous Positive Airway Pressure) to treat his sleep apnea, then his maximum heart rate dropped to 67 bpm and his mean was 52 bpm! He had a nearly 50% reduction in his heart rate because we were able to eliminate the pauses in his breathing and all the stress on the body that apnea induces. Plus keep in mind that this was his first night on CPAP and it was in a sleep lab with wires attached to him. It will surely be even better when he is sleeping in his own bed and he becomes more accustomed to CPAP.
Sleep disorders are still one of the most overlooked causes of cardio-vascular disease. Yet, there are more and more sleep centers and sleep physicians who can work with your internist and cardiologist to help find the optimal treatment plan. To find the best sleep center near you, go the American Academy of Sleep Medicine’s website (aasmnet.org). They list all accredited sleep centers in the US. Be sure to ask if they are a comprehensive sleep center that has a board-certified sleep specialist and which treats all sleep disorders because your problem may involve more than one sleep disorder.
