Sleep Apnea and Heart Disease

and Stroke are the most life threatening co morbidities of . The CDC reports that 610,000 people die of in the united states every year, that is 1 in 4 deaths. The link between sleep apnea and  is clear.

Heart disease is the leading cause of death in the United States, and stroke is the No. 4 cause and a leading cause of disability. High blood pressure is a major risk factor for both.”– American Heart Association

Patients with heart conditions often report that their cardiologist seems unaware or uninterested in sleep patterns. Whenever I have had the opportunity at major sleep meetings I have discussed this matter with sleep diagnostic professionals. It is generally accepted that cardiologists tend not to refer patients for sleep studies at the same rate as other physicians even as the risk of OSA in heart disease patients is higher then the general population. The Journal of the American College of Cardiology reports Obstructive sleep apnea (OSA) affects an estimated 15 million adult Americans and is present in a large proportion of patients with hypertension and in those with other cardiovascular disorders, including coronary artery disease, stroke, and atrial fibrillation. In contrast, central sleep apnea (CSA) occurs mainly in patients with heart failure

A study was designed to test the idea that cardiologists seem to have a different attitude toward Sleep Apnea. The resulting questionnaire was called the “Obstructive Sleep Apnea Knowledge and Attitude” (OSAKA) questionnaire.was modified by the addition of 20 knowledge items and one attitude question to include a total of 38 knowledge items and six attitude questions. This questionnaire was mailed out to 518 Cardiologists in the United States.

While the response rate was low, only 60 Drs. responded to the questionnaire this was considered to be a representative sampling. The responses were revealing as 77% of the clinicians reported that OSA was very important or extremely important clinical disorder. 53% of respondents felt comfortable identifying patients at risk for the disorder and 17% felt confident in managing patients with OSA.

Conclusion

Cardiologists do appear to have good knowledge about Sleep apnea in its many forms. There does appear to be an opportunity to develop more comfort in identification and treatment of the disorder. This disconnect may well contribute to the perception that Cardiologists do not refer patients for sleep diagnostics at the same rate as other physicians.

In my opinion working within the local health community and referring identified patients for management by a sleep treatment specialist will allow the Cardiologist to focus on the heart condition while the sleep condition is managed elsewhere.

Sources

Sleep and Breathing Cardiologist’s knowledge and attitudes about obstructive sleep apnea: a survey study November 2008, Volume 12, Issue 4, pp 295–302

CDC Centers for disease control Heart Disease Facts retrieved from http://www.cdc.gov/heartdisease/facts.htm

American Heart Association: Sleep Apnea and Heart Disease, Stroke retrieved from http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Sleep-Apnea-and-Heart-Disease-Stroke_UCM_441857_Article.jsp#.V6ECSGO75px

Journal of the American cardiology Association: Volume 52, Issue 8, August 2008 Sleep Apnea and Cardiovascular disease retrieved from http://content.onlinejacc.org/article.aspx?articleid=1139136&resultClick=3

 

Bradley Eli DMD, MS

Bradley Eli DMD, MS

Dr. Brad Eli is a nationally recognized leader in pain management and sleep disorders treatment. He has developed a multi-disciplinary approach to treat acute and chronic orofacial pain including migraines, stress and tension headaches, myofascial pain, neuralgia, temporomandibular disorders (TMD), Sleep Bruxism, and head and neck injuries. Refined techniques include behavior modification, psychology, physical medicine, and anesthesiology. His expertise in sleep led him to develop a patient centered method that offers a variety of sleep treatment options and matches each patient with the best treatment for their symptoms and life style. Dr. Eli understands how much chronic/acute pain can limit and negatively impact a person’s life, so he is tenacious about finding whatever is the right method is to help a patient so they can not only live a better life, but they can wake up knowing their day isn’t going to be defined by their pain.

Dr Eli earned a post-doctoral master’s Degree at UCLA where he received advanced training in the field of orofacial pain and the treatment of sleep disordered breathing. He remains the only specialist with this unique skill set in the San Diego region. He is a member of and teaches for numerous professional associations including the American Headache Society, American Academy of Sleep Medicine and the American Academy of Dental Sleep Medicine. He maintains offices in San Diego county, where he is on the staff at both Scripps Memorial Hospital, La Jolla and Encinitas, Tri-City Medical Center, and Palomar Medical Center. Dr. Eli is the first specialist of this type in San Diego and works with multiple insurance plans, including Medicare and Tricare. www.sleeptreatmentspecialists.com

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