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Health Information Discover Rush Fall 2008

Experiencing Daily Drowsiness?

Sleep Apnea Could Be At the Heart of the Problem

If you struggle to get out of bed every morning and feel drowsy all day, you might need more than a strong cup of coffee. You might need to see your doctor. The problem may be a disorder called sleep apnea, and it could affect your heart health.

Troubled Breathing, Troubled Heart

Sleep apnea causes you to stop breathing temporarily while you sleep. There are two types of the condition: obstructive and central. Both are related to heart disease, but in different ways.

Survival instinct at work. Obstructive sleep apnea is more common, and the single biggest risk factor for it is obesity. Being overweight can cause tissue buildup in the neck, mouth and back of the throat, crowding the airway. When you’re awake, muscle tension keeps the airway open. But the work of holding open the extra tissue fatigues these muscles, making them more likely to collapse during sleep.

“When you’re sleeping, you can suck the airway closed for more than 10 seconds, sometimes as long as one or two minutes,” says James Wyatt, PhD, director of the Sleep Disorders Center at Rush University Medical Center.

This sends warning signals to your brain, activating your fight-or-flight response. You awaken abruptly, take a few deep breaths and fall back asleep; since you’re unlikely to remember waking up, you probably won’t know it’s happening —except for the telltale daily drowsiness.

Your fight-or-flight response also causes temporary physiological changes, such as an increased heart rate and a spike in blood pressure.

“If untreated, eventually these physiological changes will either cause or worsen existing high blood pressure and heart disease, and elevate your risk for heart attack or stroke,” Wyatt says.

Muscles asleep on the job. Central sleep apnea occurs when the respiratory muscles actually stop trying to breathe. Causes include some narcotic pain medications (like morphine), brain disease (such as a tumor or the effects of a stroke) and some heart conditions (such as congestive heart failure or atrial fibrillation).

Sleep To Your Heart’s Content

“We have a lot of patients with heart rhythm problems, heart failure or high blood pressure caused by undiagnosed sleep apnea,” says Jeffrey Soble, MD, a cardiologist at Rush. “Treating heart problems is more difficult if the underlying problem of sleep apnea has not been diagnosed, which makes it all the more important to check for surprising connections to heart issues, like sleep disorders.”

Treatment of obstructive or central sleep apnea depends on the underlying problem and might include weight loss, treatment for heart problems (which may help prevent central sleep apnea), and continuous positive airway pressure (which blows air into your nose during sleep to keep airways open).

If drowsiness is a daily occurrence for you, take our interactive sleep disorders quiz to help determine what could be at the heart of your problem. Visit



Sleep Disorders Services
at Rush

Rush University Medical Center in Chicago, Illinois, is home to the world-class Sleep Disorders Services and Research Center, where we take a multidisciplinary approach to evaluation, diagnosis and treatment of sleep disorders. The center includes specialists in pulmonary medicine, neurology and psychology, who are all board-certified in sleep medicine. The center is nationally known for its leadership in the field of both sleep medicine and research.

For more information about care for sleep disorders at Rush visit the Sleep Disorders Services and Research Center home page.

Or find out more information about your particular sleep problems with our unique, interactive conversation about sleep. This Web-based tool uses a friendly, conversational tone to help you explore your personal sleep issues in depth by asking pertinent questions that lead you to targeted information.

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