Why Heart Patients Must Have a Home Sleep Study: The Brain and the Heart

At the Kahn Center, we emphasize lifestyle and corrective measures to promote health and prevent or reverse illness. One factor often ignored is the quality and quantity of sleep. Sleep apnea has become a major factor for cardiovascular and overall health and is easily tested at the Kahn Center by a high-quality home sleep study. The quantity of sleep also matters. 

Sleep apnea, including obstructive sleep apnea and central sleep apnea, can affect people of all ages but it is most prevalent in middle-aged and older adults.

Some symptoms of sleep apnea that a person may detect on their own include:

• sleepiness during the day
• headaches
• difficulty focusing
• snoring
• Unexplained weight gain, arrhythmias, and high blood pressure
• a patient's partner may notice snoring or gasping for breath while asleep.

New research this week indicates the serious implications of undiagnosed and untreated sleep apnea and short sleep durations.

STUDY 1: Sleep Apnea and Memory

In a study that will be presented next month at a major neurology meeting, 4,257 participants completed a questionnaire asking about sleep quality as well as memory and thinking problems. For sleep, participants were asked about snoring, gasping, or breathing pauses in their sleep. For memory and thinking, participants were asked questions related to difficulty remembering, periods of confusion, difficulty concentrating, or problems with decision-making.

Of all participants, 1,079 reported symptoms of sleep apnea. Of those with symptoms, 357 people, or 33%, reported memory or thinking problems compared to 628 people, or 20% of people without sleep apnea symptoms.

After adjusting for other factors that could affect memory and thinking problems, such as age, race, gender, and education, researchers found that people who reported sleep apnea symptoms were about 50% more likely to also report having memory or thinking problems compared to people who did not have sleep apnea symptoms.

The lead researcher said: “These findings highlight the importance of early screening for sleep apnea. Effective treatments like continuous positive airway pressure (CPAP) machines are readily available. Quality sleep, along with eating a healthy diet, regular exercise, social engagement, and cognitive stimulation may ultimately reduce a person’s risk of thinking and memory problems, improving their quality of life.”

STUDY 2: Short Sleep and Diabetes 2 Risk

Using the UK Biobank,  247 867 participants were categorized into 4 sleep duration groups: normal (7-8 hours per day), mild short (6 hours per day), moderate short (5 hours per day), and extreme short (3-4 hours per day). Their dietary habits were evaluated based on population-specific consumption of red meat, processed meat, fruits, vegetables, and fish, resulting in a healthy diet score ranging from 0 (unhealthiest) to 5 (healthiest). In follow-up, the risk of Type 2 diabetes mellitus (T2D) was measured. 

The results indicated a significant increase in the risk of T2D among participants with 5 hours or less of daily sleep. Individuals sleeping 5 hours per day exhibited a 16% increase, and individuals sleeping 3 to 4 hours per day exhibited a 41% increase compared with individuals with normal sleep duration. Furthermore, individuals with the healthiest dietary patterns had a reduced risk of T2D by 25%. The association between short sleep duration and increased risk of T2D persisted even for individuals following a healthy diet.

CONCLUSIONS

Sleep of short duration or sleep that is interrupted by sleep apnea is a major risk for heart disease, brain disease, and diabetes type 2. These two new studies add to the imperative to test for sleep apnea and to obtain thorough histories of sleep quantity in patients.

Home sleep studies have become simple, accurate, widely available, and inexpensive. 

Sleep health assessment is a new vital sign after blood pressure, heart weight, respiratory rate, weight, and temperature.