Get Screened for and Manage Sleep Apnea
Untreated sleep apnea adds real strain to an already thickened heart, says Smith. “Each pause in breathing raises pressure, triggers stress hormones that can worsen obstruction, and increases the risk of irregular heartbeats like atrial fibrillation,” he says.
Repeated drops in oxygen overnight may also contribute to scarring of the heart muscle over time. In a study of more than 200 people with obstructive HCM, sleep apnea and its severity were independently linked to greater scarring on cardiac MRI, and that scarring is associated with worse long-term outcomes.
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“We know treating OSA in more general cardiology patients is very beneficial,” says Smith.
Somers and his colleagues have published research on how sleep apnea affects the body’s stress response and blood vessel function in people with HCM. In a study of more than 230 patients, those with untreated sleep apnea had higher stress hormone levels, higher blood pressure, and more impaired blood vessel function than those without sleep apnea, all of which were linked to a higher risk of major cardiac events during follow-up.
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- Disruptive snoring at night, especially if it’s loud enough to wake a bed partner
- Gasping or choking sounds during sleep
- Morning headaches or a dry mouth upon waking
- Severe daytime sleepiness or fatigue, even after what seems like enough sleep
Every oHCM patient should be asked directly about sleep symptoms, regardless of whether they fit the profile of a “typical” person with sleep apnea, says Smith. If concerns come up, your doctor may refer you to a sleep specialist or order an overnight sleep study, he says.
“An in-lab study is usually better than an at-home one, since it can better detect heart-related events during sleep,” he says.
