Sleep Apnea-Related Heart Palpitations

Heart palpitations, an unusually fast beating or fluttering of the heart, can be disquieting but happen to everyone occasionally. The usual causes are stress, medications or exercise -- but they can also be indicative of an underlying medical condition.

When palpitations become a regular occurrence, it could be symptomatic of serious heart issues such as arrhythmia (irregular heartbeat) or heart disease. If palpitations persist, it is unwise to simply ignore the problem -- and a doctor should always be consulted as treatment may be required.

Heart palpitations can occur at any time but are obviously more noticeable when awake. This can be an issue for people with obstructive sleep apnea as the palpitations often go unnoticed. 

The breathing pauses or “apneas” caused by the condition put additional strain on the heart -- and researchers have established a connection between obstructive sleep apnea and the onset of several rhythm disorders of the heart.

Heart Issues

Obstructive sleep apnea, or OSA, causes intermittent pauses in breathing during sleep as the air passage becomes blocked. In order to clear the airway, the body reacts by waking briefly, clearing the blockage and restoring a normal breathing pattern. 

However, this stop-start exercise has an effect on the heart and interferes with the normal rhythm. It is estimated that approximately a quarter of patients using a pacemaker also suffer with OSA. Although not conclusive, this has led to speculation that there may be a link between OSA and arrhythmia as well as other heart conditions.

Other studies have shown that sleep apnea sufferers are more prone to heart issues -- and this is because the strains that OSA place on the body also put additional pressure on the heart. Conversely, people with existing heart conditions are also more likely to develop sleep apnea.

Recognizing Heart Palpitations

Heart palpitations can be so minor as to be almost unnoticeable. They can occur after exercise, a sudden burst of activity, during periods of stress or for no apparent reason at all. The usual symptoms are:

Noticeable increase in heart rate

Heart fluttering

Strong, pounding heartbeat

Missing heartbeats

Momentary weakness or feeling light-headed

Depending on the frequency, severity and underlying cause of the attacks, further medical investigation may be required. Occasional palpitations are normal and usually nothing to be concerned about. But if these incidents become a regular occurrence, it is time to have the root cause investigated.

How Sleep Apnea Affects the Heart

Because the oxygen supply is temporarily shut off during sleep, this has a direct effect on the functioning of the heart. If high blood pressure exists, this needs to be evaluated by a physician to determine if medication is required. PAP therapy can lower one’s resting blood pressure by easing the work of breathing.

Muscle Damage. The body reacts to the shortage of oxygen by attempting to make the heart pump more strongly or quickly in order to get more oxygenated blood into circulation. 

Over a long period of time, this can lead to the heart muscles becoming enlarged or even worn out. In such cases, the heart becomes less effective and the levels of functionality decrease. Left untreated congestive heart failure can develop.

Damaged Blood Cells. The decrease in oxygen levels can also damage blood cells in the heart -- causing scarring and thickening which reduces the blood flow.

The longer obstructive sleep apnea is left untreated the greater the likelihood of heart issues and damage. As time passes, the damage caused increases until it becomes irreversible and medical intervention, or even surgery, is required. This is one of the reasons that obstructive sleep apnea should never be simply ignored but treated as soon as possible.

Does PAP Therapy Help?

The use of positive airway pressure (PAP) therapy is widely recognized as the best form of treatment for OSA -- but can it also help control sleep apnea-related heart palpitations? This is a question for which there is no definitive answer.

PAP devices function by forcing pressurized air into the air passage thus keeping the airway clear and avoiding the gaps in breathing caused by sleep apnea. This should certainly reduce unnecessary stress on the heart and reduce the likelihood of adverse reactions such as palpitations and arrhythmia.

The key to success is to begin PAP therapy at the earliest possible time, as damage to the heart is cumulative and will only worsen the longer the heart is put under pressure. It cannot be stated as an absolute certainty that PAP treatment will resolve issues such as sleep apnea heart palpitations -- but this form of treatment can certainly be beneficial.

There is some limited research that indicates PAP therapy can help improve the functionality of the heart's left ventricle -- and even reverse minor heart damage caused by OSA but this is, as yet, far from conclusive. 

However, PAP therapy has been proven very effective in treating OSA and this alone will help with reducing pressure on the heart and the associated ailments that can accompany the condition.

It should not be assumed that PAP therapy is the answer to heart palpitations or other heart issues and medical advice should always be sought if there is even the slightest cause for concern. 

A good night's sleep is crucial for overall health -- and PAP treatment can help achieve this goal for OSA sufferers. PAP treatment, however, should not be viewed as a cure-all for issues with the heart which may, or may not, be linked to obstructive sleep apnea. 

Any issues with the heart, even one as relatively minor as palpitations, should always be taken seriously and professional assistance sought if any problems persist or are causing concern.