WHY YOU CAN’T STAY AWAKE: THE DANGERS OF SLEEP APNEA – OTHER CARDIAC COMPLICATIONS AND OTHER RISKS
Other Cardiac Complications
Apnea has been shown to lead to chronic heart disease or cardiopulmonary failure, causing a buildup of toxins and acids in the blood. Hypoxemia (lowered oxygen), which results in lowered cardiac output, increases the risk of strokes or myocardial ischemia. It may also generate one or more types of irregular heartbeats, some of which can be lethal. Incidence of some heart problems is at its highest during the early-morning hours, a phenomenon which many experts feel is related to breathing disturbances during sleep. OSA is thought to be responsible for as many as two to three thousand cases each year of sudden death during sleep.
Lowered blood output means that less blood, and thus less oxygen, is circulated to the brain. Naturally this has a detrimental effect on brain-stem functioning; the brain becomes less able to work at overcoming the problem of disordered breathing, thus causing further hypoxemia. Unless this vicious circle is broken, the apneas will become more frequent and prolonged, and symptoms will worsen, starting with restless sleep and excessive daytime sleepiness and eventually progressing to stupor or even coma. Apnea may also contribute to the decline of mental functioning associated with aging, resulting in loss of memory, diminished attention span, confusion, and impaired cognitive and motor performance. Some patients report changes in personality, including irritability and mood swings. In some cases apnea leads to problems of impotence, diminished sex drive, bed-wetting, and, in men, difficulty with erection and ejaculation.
Sickle-cell anemia poses a special risk for OSA victims, since lowered oxygen saturation at night can precipitate an anemic crisis. Similarly, polycythemia—elevation of the total red cell mass—may occur due to episodes of apnea resulting in lowered oxygen in the arteries.
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