Good Sleep Helps Keep a Heart Healthy

Sleep apnea in women increases risk of heart attack but CPAP helps

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Obstructive sleep apnea is already known to increase the risk of cardiovascular problems in men, but women appear to be at risk of heart attack if they have sleep apnea as well.

Even though the disorder is much more common in men, up to 3 percent of women have sleep apnea.

"Seek help for sleeping disorders to avoid heart problems."

"In the past we have assumed that the prototype of a person with sleep apnea was a fat, middle-aged male," said Dr. William Kohler, director of the Florida Sleep Institute in Spring Hill, Florida, who was not associated with this study.

"But sleep apnea can occur at any age, at any size and with either sex," Kohler said.

According to Dr. Francisco Campos-Rodriguez, lead author of the study and director of the Sleep-Disordered Breathing Unit at Valme University Hospital in Seville, Spain, women with untreated sleep apnea are three and a half times more likely to die of cardiovascular disease than women without the sleep disorder.

Using CPAP therapy (continuous positive airway pressure), however, women can reduce their risk of heart attack.

CPAP therapy usually involves using a machine that pushes pressurized air into a person's airways, usually through a mask that patients wear while asleep.

Campos-Rodriguez's study involved 1,116 middle-aged women with suspected sleep apnea who were studied in two sleep clinics in Spain between 1998 and 2007.

They divided the women who had sleep apnea into mild-to-moderate and severe groups. Some women in each group were treated with CPAP and others were not.

The researchers followed the women with and without sleep apnea for three to seven years, and 4 percent (41 women) of all those in the study died of cardiovascular problems.

Those with sleep apnea were more likely to to die of a heart attack, especially if their condition was severe and untreated.

Women with sleep apnea who were receiving CPAP treatment died of heart attacks at about the same rate as women without the sleeping disorder.

Because the study was observational, the researchers cautioned that the association between sleep apnea and heart attacks does not necessarily mean that the apnea caused the cardiovascular problems.

Kohler said the large sample size and prospective nature of this study makes it valuable, but one of its limitations relates to the women's compliance - how long they wore their CPAP masks while asleep.

"We know from the article that each person utilized it longer than four hours in most cases, but we don't know how long each of them used it and the effect it had on that individual," Kohler said.

"If a patient uses the CPAP only four hours instead of eight hours, it would statistically make a difference as far as controlling the apnea and the long-term benefits it's going to have," he added.

He said using CPAP therapy provides the most benefit when it is consistently during all sleep.

"Whether it be a nap or at night, it should be used all the time when they're asleep," he said. "If they don't use it, the apneas are still occurring and still having the deleterious effects."

CPAP masks can cost between approximately $30 and $200, and CPAP machines range from about $150 to over $5,500. Most insurance plans will cover some or all of CPAP therapy equipment.

The study appears in the January 17 issue of the Annals of Internal Medicine. The authors disclosed no financial conflicts of interest.

Reviewed by: 
Review Date: 
January 18, 2012
Last Updated:
January 18, 2012