Why Cardiologists Should Treat Sleep Apnea

Heart disease is the leading cause of death in the United States, and the latest statistics are quite sobering. According to The Centers for Disease Control and Prevention, one person dies every 36 seconds from cardiovascular disease. Approximately 655,000 Americans die from heart disease each year—which accounts for 1 in every four deaths. We associate cardiovascular wellbeing with eating a heart-healthy diet and getting regular exercise. Still, new research shows that a good night's sleep is also critical to maintaining overall cardiovascular health. Of the 92 million people who suffer from cardiovascular disease, 60% also suffer from sleep apnea.

Understanding Obstructive Sleep Apnea (OSA)

According to the American Academy of Sleep Medicine, over 30 million people in the US suffer from Obstructive Sleep Apnea (OSA), the most prevalent type of sleep apnea. OSA is characterized by frequent, repeated interruptions in breathing during sleep. While it is commonly associated with nighttime snoring and daytime sleepiness, Obstructive Sleep Apnea has severe cardiovascular comorbidities, including high blood pressure, arrhythmia, stroke, and heart failure. The correlation between OSA and cardiovascular health is best understood by examining how the body reacts during an apnea episode.

The Physiology of Sleep Apnea and Its Impact on the Heart

During a sleep apnea event, the tongue and the airway's muscles relax and collapse, resulting in obstructed airflow to the lungs. Lapses in breathing typically last between 10 to 20 seconds but can last for 30 seconds or even longer and repeatedly occur during the night. When breathing stops, oxygen levels in the blood drop. Our bodies respond by releasing the stress hormone epinephrine, more commonly known as adrenaline. This "fight or flight" response elevates the heart rate and can lead to high blood pressure. Overall, heart function decreases because it becomes less efficient at pumping blood, and the heart itself is affected because of the pressure changes taking place in the chest. According to the American College of Cardiology, patients with OSA are four times more likely to have abnormal heart rhythms, including atrial fibrillation. They are two times more likely to have a heart attack.

The Connection Between Sleep Apnea and Cardiovascular Disease

The American Academy of Sleep Medicine has well documented the relationship between sleep apnea and cardiovascular disease. In 2018 the AASM held a 1-day Sleep Medicine Sleep-Disordered Breathing Collaboration Summit to discuss advances in the diagnosis and treatment of Obstructive Sleep Apnea through a multi-disciplinary, collaborative approach. Because so many patients with cardiovascular disease also have co-morbid OSA, practitioners in sleep medicine believe cardiologists can play an essential role in furthering access to sleep care. Given the severe comorbidities associated with OSA, it is striking to learn that 85% of OSA patients remain undiagnosed and that 50% never receive treatment. In the June 2020 issue of Cardiology Today, Dr. Carl J. Pepine, Chief Medical Editor, discussed the need for collaboration and innovation in treating his patients with OSA, stating, "This is a very important topic for our patients with CVD, but unfortunately, many patients that I refer to our sleep center do not want to undertake a night in the center for a formal sleep study."

Challenges in Sleep Management

Dr. Pepine's frustration exemplifies the shortcomings of today's sleep management system. Because cardiovascular disease and Obstructive Sleep Apnea are so intertwined, it makes sense for cardiologists to diagnose and treat their patients for OSA. But they need to work with a system that sees their role as a valued partner and centers on the patient experience. Our current sleep management system offers silos of treatment spread among diverse specialists, labs, and durable medical equipment suppliers. Because of this uncoordinated effort, the process from diagnosis to treatment can take up to 4 months, with a low 33% long-term adherence rate.

A Comprehensive Solution: BetterNight

BetterNight provides a comprehensive sleep care solution that works in collaboration with cardiologists. As a telehealth platform, BetterNight provides patient screening, diagnosis, and treatment all from the comfort of home via a computer, tablet, or mobile device. The first step is an initial consultation with a board-certified sleep physician, followed by an in-home sleep test to diagnose your patient's sleep condition further. Once a treatment plan is determined, BetterNight prescribes and delivers the needed therapy device directly to your patient. Proprietary software helps BetterNight obtain detailed data from Continuous Positive Airway Pressure therapy device. This data is monitored daily to assure your patients are receiving the best care possible and can be shared with you if desired, keeping you actively involved in your patient's sleep care journey.

Collaborative Care for Improved Outcomes

When cardiologists partner with BetterNight, they feel confident knowing their patients won't get lost in the sleep medicine system. Your patients will be treated by a team of sleep medicine professionals, including respiratory therapists, polysomnographic technicians, and Cognitive Behavioral Therapy counselors who are uniquely trained in their respective fields and are dedicated to providing the best in sleep medicine. BeterNight's cross-disciplinary approach brings the best of sleep medicine to your practice resulting in improved sleep and cardiovascular health.

Ready to integrate BetterNight into your cardiology practice today? Learn more by contacting Kim D’Ambra.