WEDNESDAY, Oct. 24 (HealthDay News) -- In a surprising finding,
people with sleep apnea appear to suffer less heart damage during a
nonfatal heart attack than those without the condition, researchers
report.
In obstructive sleep apnea, a person's breathing is disrupted
during sleep because their airway becomes narrowed or blocked,
causing pauses or decreases in air flow.
Although the new findings do not contradict the widely accepted
view that sleep apnea is a risk factor for heart disease that can
lead to a heart attack, they do suggest that obstructive sleep
apnea can provide some heart protection in the event of a heart
attack, explained lead investigator Dr. Neomi Shah, associate
director of the pulmonary sleep lab at Montefiore Medical Center in
New York City.
One heart expert called the finding "intriguing."
"It is counter-intuitive to what we would expect," said Dr. Howard Weintraub, a clinical associate professor in the department of medicine at NYU Langone Medical Center, in New York City. He theorized that sleep apnea might reduce the damage from heart attack "due to patients [with apnea] being accustomed to lower levels of oxygen in their blood during apneic periods."
In the study, the Montefiore team looked at more than 130 heart
attack patients. Their median age was 58, and 35 percent had
obstructive sleep apnea.
People with the condition were significantly older than those
without it (62 years versus 52 years, on average), the study
authors noted in a Montefiore news release.
Patients with obstructive sleep apnea had lower blood levels of
Troponin-T, a marker for heart cell death that accurately predicts
heart attack severity, and lower levels of an enzyme that indicates
injury or stress in heart muscle, the investigators found.
The study was published Oct. 24 in the journal
Sleep and Breathing.
Although the study found an association between having sleep
apnea and experiencing less heart damage during a nonfatal attack,
it did not prove a cause-and-effect relationship.
Another cardiologist believes the study might have some
weaknesses.
"Of the patients screened for the study, only about 1 percent ... were enrolled in the registry; this is a very low number for most studies," noted Dr. Stephen Green, associate chairman of the department of cardiology at North Shore University Hospital in Manhasset, N.Y.
He also pointed out that the study "says that patients with
sleep apnea have smaller heart attacks than those without sleep
apnea. It does not say that people with sleep apnea have less heart
attacks, and cannot say this."
Weintraub agreed.
"Sleep apnea may potentially result in more frequent, but less damaging, heart attacks," he said. Therefore, he added, "even in light of this information, I would strongly endorse appropriate treatment of sleep apnea."
Green also noted that "the diagnosis of [heart attack] was made
by Troponin levels, which may be oversensitive, and especially in
patients having breathing problems. It is not clear that heart
doctors would consider all of the Troponin elevations to be heart
attacks."
More information
The U.S. National Heart, Lung, and Blood Institute has more
about
sleep apnea.