The danger of heart attack during sleep

Chest Diseases Specialist Dr. Sibel Meryem Alpar provided information regarding sleep apnea.

Defining sleep apnea and discussing its effects on the individual, Dr. Alpar said, "Sleep apnea is a significant sleep disorder where breathing becomes difficult due to the obstruction of the upper respiratory tract, and breathing repeatedly stops and starts during sleep. During this process, oxygen levels in the blood drop, and oxygen delivery to tissues decreases. This lack of oxygen causes the patient to wake up, and oxygen levels only return to normal after the patient wakes. These fluctuations in blood oxygen levels are a characteristic feature of the disease. This most commonly observed condition is called obstructive sleep apnea syndrome. The other type of apnea is central apnea, where the brain fails to control breathing properly. Sleep apnea is defined as the cessation of breathing for at least 10 seconds due to the relaxation of upper respiratory tract muscles or the obstruction of the airway by the soft palate or enlarged tonsils. This obstruction can last from a few seconds to several minutes. There are three types of sleep apnea: central, obstructive, and mixed," she stated.

Emphasizing that symptoms include severe snoring at night, difficulty breathing or occasional pauses in breathing and sudden awakenings noticed by partners even if the patients themselves are unaware, sweating on the neck and head, increased frequency of nighttime urination, dry mouth, morning headaches, reflux, decreased concentration, excessive daytime sleepiness, and extreme irritability, Alpar warned that these symptoms should not be ignored.

"THE MOST IMPORTANT RISK FACTOR IS OBESITY"

Noting that sleep apnea can be seen at any age but is more common between the ages of 40 and 70, Alpar said, "The most important risk factor is obesity. It is seen more frequently in men. Structural disorders in the nose, throat, or jaw, certain endocrine disorders (hypothyroidism, acromegaly), and genetic predisposition are among the other risk factors."

"IT CAN LEAD TO DIFFERENT DISEASES"

Stating that recent research shows snoring and sleep apnea are associated with many very important diseases, Alpar said, "Sleep apnea syndrome paves the way for hypertension, diabetes, hyperlipidemia, and obesity. Sleep apnea syndrome, which is an independent risk factor for diseases such as heart attack and stroke, must be treated."

Dr. Alpar stated that untreated sleep apnea leads to conditions such as arrhythmia, heart enlargement, increased risk of heart attack, high blood pressure, stroke, excessive fatigue and daytime sleepiness, traffic accidents (falling asleep at the wheel), decreased sexual desire (impotence), weight gain, sweating during sleep, frequent urination, irritability, depression, and death during sleep.

"THE PATIENT IS EXAMINED BY STAYING ONE NIGHT IN A SLEEP LABORATORY"

Discussing the diagnostic process, Dr. Alpar said, "The sleep apnea test performed by a physician is very important for the detection and treatment of the disease. The patient is examined by staying one night in a sleep laboratory. The sleep apnea test, called 'polysomnography,' is a test where brain activity and respiratory events are recorded throughout the night. With this test, parameters such as electroencephalography (EEG), electrocardiography (ECG), electrooculography (EOG), electromyography (EMG), respiratory effort including chest and abdominal movement recording, airflow recording from the nose and mouth, oxygen saturation, and body position are monitored throughout the night. The diagnosis of the disease is made when respiratory disorder scores during night sleep are at a pathological level as a result of the sleep test. Patients whose calculated abnormal respiratory events are above acceptable values are diagnosed with 'Sleep Apnea Syndrome'."

TREATMENT OPTIONS

Explaining the treatment methods, Dr. Alpar said, "Fighting obesity plays an important role in the treatment of sleep apnea. An Ear, Nose, and Throat (ENT) examination is very important for the detection and treatment of anatomical narrowings and pathologies in the upper respiratory tract. If no surgical indication is found by the ENT department, the most widely used sleep apnea treatment in the world is 'Continuous Positive Airway Pressure (CPAP)' therapy. This sleep apnea device provides very precise positive pressure air through a silicone mask that fits tightly on the face throughout the night; there may be difficulty in adapting to these devices in the first few days. However, in the following days, patients who achieve restful and quality sleep use the device easily. A second night in the sleep laboratory is required to determine which device and pressure are appropriate for the patient. No medication is used and no surgical procedure is performed in this treatment. The effects of CPAP are seen the very next day."

News Source: İHA