While it may not be on the top of your list as a cardiologist, sleep apnea can have a serious impact on the cardiovascular health of your patients. As a specialist, your patients trust in you to keep them aware of both new and ongoing conditions that can challenge their quality of life, and sleep apnea is a pretty insidious one for a few different reasons.
First, sleep apnea can often go undiagnosed because the person may never be aware that they have it. Second, if your patient doesn’t specifically bring it up with you, you may not be able to see its signs or symptoms from simple follow up visits. And, lastly, undiagnosed sleep apnea can indicate a much larger, more impactful problem: heart failure.
Sleep Apnea and Heart Failure: A Serious Problem
You already know that heart failure is a long-term problem that can worsen as time passes. It is progressive and chronic, so maintenance and monitoring are critical to maintain a good quality of life for the patient. However, an already weakened heart muscle makes the prospect of untreated sleep apnea much more frightening because this sleep disorder puts extra, undue strain on the heart when it enters “panic mode.”
Sleep apnea is categorized as a disorder where an individual stops breathing several times a night, often more than 10 apnea events in an hour or more. When the body stops breathing, it attempts to correct the problem to stop the suffocation that happens when the airways are blocked. The “panic” that ensues can include coughing, choking, and an elevated heart rate. All of these attempt to clear the airway and can all happen while the subject is still asleep--this is why sleep apnea is often underdiagnosed.
How are Heart Failure & Sleep Apnea Related?
If a patient is already diagnosed with heart failure, OSA can increase negative side effects or other, potentially more deadly, events like heart attacks. However, it can also work the other way. Patients who may never have experienced OSA can develop the condition after experiencing heart failure, as some elements of heart failure can result in collapsed areas of the upper airways.
Similarly, heart failure often includes a shifting in internal fluids from the legs to central structures (i.e. peripheral edema). This is especially common when patients lay down, and can lead to the narrowing of airways, blocking air flow and leading to sleep apnea.
To get a full picture of this bi-directional relationship, examine the chart below provided by the Cardio Sleep Review:
What This Means for Cardiologists
It is important for cardiologists to understand the close and complicated link between heart failure and sleep apnea. In two different studies that focused on the connection between heart health and sleep, one found a 37% correlations between heart failure and sleep apnea. The other found an 11% correlation between heart failure and severe sleep apnea, which is characterized by >10 apnea events in an hour.
Cardiologists are qualified to diagnose sleep apnea and treatments, but you must get your patients to undergo a sleep study to get the results you need for a firm diagnosis. There are two central ways you can do this: one, refer your patient to a sleep lab for a complex polysomnography. Or, two, partner with ApneaMed to give your patients the cheaper, more comfortable at-home sleep testing (HST) options.
How ApneaMed Can Help
ApneaMed provides practices and clinics like yours with the option to either carry your own home sleep test unit or participate in other referral programs so your patients can test from the comfort of their own home, in their own bed. ApneaMed recommends our In-Office Partnership where we will send you a home sleep test to keep in your office and lend out to your patients. This way, you can get them their testing unit, results, and treatment much sooner--often in 3-4 business days.
A polysomnography can take substantially longer--between waiting, testing, analysis, results, and prescription, your patients can often wait up to 3 months for answers and treatment options. With ApneaMed and home sleep testing, there are fewer pieces of data to analyze, which means our board-certified sleep physicians can read that data quicker and get your patients connected with treatment options quicker.
Other Partnership Options
However, if you feel that the In-Office Partnership does not work for you, we also have a Referral Partnership and a Mail-Out Partnership. In the referral option, you can refer your patients to ApneaMed and we will reach out to the patient directly for testing and, if appropriate, individualized treatment options.
In the Mail-Out Partnership, you order a HST unit from ApneaMed to be sent directly to your patients. After your patient undergoes testing, ApneaMed will work directly with your patient to get them the best treatment if they are diagnosed with sleep apnea.
Regardless of which option you feel is best for your practice, it’s imperative that you are aware of the intricate connections between heart failure and OSA. It doesn’t matter which condition caused the other because both can make your patient’s quality of life much worse than it needs to be. Do you research on the connections between these two conditions and then reach out to ApneaMed so we can help your patients get the treatment and sleep they deserve.