How Obstructive Sleep Apnea Raises the Risk of Heart Disease

Obstructive Sleep Apnea (OSA) is often left untreated, but this common sleep disorder has an alarming dark side—it raises your risk of heart disease. What seems like a simple nighttime nuisance can actually have serious consequences for your overall health.

In this article, we will uncover how OSA impacts your heart according to a comprehensive study led by DiCaro. Also, we’ll talk about why addressing OSA promptly is so important.

How OSA Increases Heart Disease Risk

OSA occurs when the muscles in the throat relax excessively during sleep, blocking the airway. This leads to repeated episodes of stopped or shallow breathing, called "apneas." Each episode results in a drop in oxygen levels in the blood. In response, the body activates the nervous system, which increases heart rate and blood pressure. These disruptions create a domino effect that puts a significant strain on the heart and blood vessels, leading to long-term damage.

OSA raises the risk of heart problems through several harmful mechanisms.

One of the main ways is by over-activating the body’s stress response. When breathing stops during sleep, the body reacts as though it’s in danger, releasing stress hormones like adrenaline. These hormones increase heart rate, raise blood pressure, and put extra strain on the heart.

Additionally, the drop in oxygen levels during apnea episodes causes a condition called intermittent hypoxia. This triggers inflammation and oxidative stress, where unstable molecules damage blood vessels. Over time, these processes narrow the blood vessels, promote fatty plaque buildup, and increase the risk of blood clots.

Another issue is the physical pressure changes that occur in the chest during apnea episodes. When a person struggles to breathe, the chest creates negative pressure to pull in air. This pressure increases the workload on the heart, making it harder to pump blood efficiently.

Specific Heart Problems Linked to OSA

Untreated sleep apnea is linked to several serious heart conditions.

Arrhythmias

Irregular heartbeats, or arrhythmias, are common in people with OSA, as supported by a study by Geovanini and Lorenzi-Filho. One of the most well-known arrhythmias is atrial fibrillation (AF), which is characterized by the heart beating irregularly. OSA makes AF more likely to develop, harder to treat, and more likely to return after treatment. Other arrhythmias, such as slow heart rates (bradycardia) and life-threatening fast heart rhythms (ventricular tachycardia), are also linked to OSA.

Hypertension

Hypertension or high blood pressure is another major risk connected to OSA. Sleep apnea is a key cause of resistant hypertension, which does not respond well to medication. The repeated stress caused by apnea episodes raises blood pressure both at night and during the day, keeping the cardiovascular system under constant strain.

Heart Failure

Heart failure is another condition closely tied to OSA. The disorder weakens the heart’s ability to pump blood effectively, leading to symptoms like shortness of breath, fatigue, and swelling. OSA can worsen both right-sided and left-sided heart failure by straining the heart muscles.

Coronary artery disease

Coronary artery disease (CAD) is also more common in people with OSA. The inflammation and stress caused by apnea episodes promote plaque buildup in the arteries that supply blood to the heart. This increases the risk of chest pain, heart attacks, and even sudden cardiac death.

Stroke

Finally, OSA raises the risk of stroke and is a co-morbid condition in stroke patients. By promoting blood clots, damaging blood vessels, and disrupting blood flow, OSA creates a perfect storm for cerebrovascular problems. The risk is particularly high for older adults and those with untreated severe OSA.

Who is Most at Risk?

OSA affects different people in different ways. Men are more likely to develop the condition, but women with OSA face a higher risk of dying from heart-related problems. Older adults are also more vulnerable, especially to hypertension and strokes. People with obesity are at the highest risk for sleep apnea, as extra fat around the throat worsens airway blockages during sleep.

The Role of Treatment in Protecting the Heart

The good news is that treating Obstructive Sleep Apnea does more than improve sleep. It can also greatly reduce the risk of serious heart problems. There are several effective treatments available, and choosing the right one can make a big difference.

One of the most effective options is Bilevel Positive Airway Pressure (BiPAP) therapy, which offers distinct advantages over Continuous Positive Airway Pressure (CPAP). While CPAP delivers a steady flow of air at a constant pressure to keep the airway open, BiPAP provides two levels of pressure: a higher one during inhalation and a lower one during exhalation. This dual-level system makes breathing more comfortable, especially for individuals who struggle with CPAP or have conditions like heart failure or central sleep apnea.

CPAP therapy, though widely used, also offers proven benefits. By delivering a constant flow of air, it helps maintain airway patency, reducing apneas and their harmful effects. Research shows that CPAP can lower blood pressure, reduce the recurrence of arrhythmias like atrial fibrillation, and prevent further heart damage in people with heart failure. However, for those requiring a more comfortable approach, BPAP often emerges as the superior choice.

Lifestyle changes play a critical role in managing OSA and protecting heart health. Losing weight, quitting smoking, and cutting back on alcohol can significantly reduce the severity of OSA. Regular exercise not only boosts sleep quality but also improves cardiovascular health.

Other treatment options include oral appliances, which are custom-made devices worn in the mouth to keep the airway open during sleep, and surgical procedures that remove excess throat tissue or stimulate the tongue nerve to avoid airway collapse.

When it comes to OSA treatment, the key is finding the most effective and comfortable solution.

Why Treating OSA Matters for Your Heart

Untreated OSA is a hidden threat to your cardiovascular health. The repeated strain on the heart increases the risk of life-changing conditions like heart attacks, strokes, and heart failure. Fortunately, effective treatments, especially BiPAP therapy, can break this cycle of damage. By improving breathing during sleep, these treatments protect the heart, reduce inflammation, and lower blood pressure—ultimately improving quality of life and life expectancy.

Obstructive Sleep Apnea is a serious risk factor for heart disease and other major health problems. If you or someone you know struggles with loud snoring, daytime fatigue, or other signs of OSA, seeking medical help is crucial. Early diagnosis and treatment can protect your heart and help you live a healthier, longer life.

The experts at Nightly are more than happy to help! In fact, you may avail a free sleep assessment to figure out the best path for your sleep disorder’s diagnosis and treatment.

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