Can Sleep Apnea Cause Heart Palpitations, and What Can You Do About It?
Many articles have been written about obstructive sleep apnea (OSA) and its long-term health effects. Common observations include weight gain, difficulty maintaining focus throughout the day, high blood pressure, and even an increased risk of developing type 2 (adult-onset) diabetes. However, another question has recently come to light.
Is there a relationship between sleep apnea and heart palpitations? Considering the fact that up to one-quarter of individuals who are currently using a pacemaker have also been diagnosed with OSA, there appears to be a link.
How Does Obstructive Sleep Apnea Affect the Heart?
Understanding how obstructive sleep apnea affects the circulatory system informs our understanding of its effect on the heart. OSA impedes the body's ability to obtain oxygen as a result of a narrowing of the airways. This is also why individuals often exhibit symptoms such as excessive snoring, and even waking up gasping for breath.
As a result of low oxygen content, the heart will respond by beating faster (an autonomic response intended to pump blood throughout the body at a higher rate). This can lead to two potential scenarios:
- The muscles of the heart can become fatigued and, on occasion, increase in size.
- A lack of oxygen may damage cardiac muscle cells, leading to issues such as scarring.
In either case, the heart could begin to exhibit specific symptoms: one telltale sign coming in the form of an irregular heartbeat.
How Might Palpitations be Triggered During a Bout of Sleep Apnea?
Now that we’ve established that sleep apnea may cause heart palpitations, let’s explore how it might happen. One possible cause is a change in pressure within the chest cavity (these are known as intrathoracic pressure changes).
Similar to breathing through a straw, the muscles within the chest cavity can be placed under a significant amount of strain. This pressure could likewise diminish how much oxygen-rich blood is able to reach the heart, as mentioned above.
The Role of the Nervous System
We are all aware that the body requires oxygen to survive. This is why humans have been equipped with what can be called an "automatic backup system" in the event that oxygen levels begin to drop. Our sympathetic and parasympathetic nervous systems may become involved – the former causing an increase in heart rate while the latter will force the heart to beat slower. Both of these situations can trigger palpitations while asleep.
A Condition Known as Myocardial Ischemia
Another concern associated with obstructive sleep apnea involves an increased risk of suffering from myocardial ischemia. Myocardial ischemia occurs when the flow of blood to the heart is reduced for a significant amount of time. This may lead to hypoxia, preventing the cardiac muscles from receiving the oxygen they require to function normally. In this instance, palpitations may occur.
Could Sleep Apnea be Causing Damage to Your Heart?
When exploring whether sleep apnea can cause heart palpitations, it’s important to note that not everyone who has been diagnosed with OSA will experience palpitations. Conversely, individuals suffering from palpitations might not always have OSA. However, there are still some important considerations.
A case of sleep apnea that has been left untreated for an extended period of time can lead to cardiac scarring (sometimes known as fibrosis), and cause palpitations. Scarring in and around the heart tends to disrupt the electrical signals that it requires to beat properly. Those with severe cardiac fibrosis are therefore at a greater risk of experiencing palpitations.
Even if you are not exhibiting any symptoms that could be attributed to cardiac issues, sleep apnea may still be present. Here are some common signs that a professional diagnosis is warranted:
- You are overweight
- You find it difficult to remain asleep
- You awaken short of breath and/or choking
- You are a loud snorer
- You are lethargic throughout the day
- You have a wider neck circumference
These are all risk factors that can increase the chances of being diagnosed with obstructive sleep apnea. So, be sure to speak with a primary healthcare provider or trained specialist to confirm a diagnosis.
Is it Possible to Reverse Damage to the Heart Caused by Sleep Apnea?
It is not a guarantee that your sleep apnea is the cause of your heart palpitations, and so OSA treatment may not be enough to mitigate cardiac symptoms.
There are also times when medications intended to treat palpitations (known as antiarrhythmic substances) may be rendered less effective if your OSA is not being addressed.
The other variable inevitably involves the severity of damage to your heart. If palpitations are treated at an early stage, it is more likely that their frequency can be reduced (or eliminated altogether). Another train of thought involves the use of a continuous positive airway pressure (CPAP) device.
A CPAP will provide air at a slightly higher pressure while you are asleep, helping your airways to remain open and enabling your body to receive the oxygen that it needs to function properly. Regularly using a CPAP device could therefore improve cardiac function. Still, it should be noted that research is ongoing.
It is crucial to seek medical advice if you are suffering from either sleep apnea or heart palpitations. Expert insight will help you determine if sleep apnea is causing your heart palpitations, and you may prevent further damage to your heart in the long run.
