As of Wednesday, March 5, 2014
DEAR DOCTOR K: I’m a snorer. I read recently that treating snoring can affect blood pressure. Can you explain the connection?
DEAR READER: Severe snoring can be a sign of obstructive sleep apnea (OSA). If you have OSA, then your breathing is blocked temporarily several (sometimes hundreds) of times per night. What happens is that muscles in your upper airway (the back of the throat) relax too much. Normally, these muscles hold your airway open, so that air moves in and out of your lungs without obstruction.
When your breathing is blocked, oxygen levels in your lungs and blood start falling. Your brain sees this happening and causes adrenaline to surge into your bloodstream. This stimulates the breathing center in your brain: It’s a “breathe now!” signal. You awaken briefly and gasp for air before falling back to sleep.
That’s bad enough. But surges of adrenaline also make your heart beat faster and raise your blood pressure. As a result, your blood pressure swings up and down.
Some people have what’s called treatment-resistant hypertension. This is blood pressure that remains high despite taking several blood pressure medications. It turns out that many people with treatment-resistant hypertension also have OSA.
A recent study in the Journal of the American Medical Association (JAMA) reported that treating OSA can help people with high blood pressure that’s difficult to control. In the study, researchers provided 12 weeks of the standard treatment for OSA to nearly 200 men and women with OSA and treatment-resistant hypertension.
The standard treatment was continuous positive airway pressure (CPAP). With CPAP, you wear a mask that covers your nose. A small machine delivers continuous air pressure that prevents the collapse of your airway.
After 12 weeks of CPAP, average blood pressures were a few ticks lower. Study participants also had healthier nighttime blood pressure patterns.
Many people find CPAP uncomfortable. As a result, they use CPAP inconsistently, or not at all.
The key is to find a mask you like. These days, you can choose from a variety of mask options, including nasal masks, full-face masks and twin tubes that deliver air to each nostril. If you don’t like the first mask you try, keep at it. You may have to try several different masks until you find one you can live — and sleep — with.
Given that we spend about a third of our entire lives asleep, it’s not surprising that our sleep could affect our health. Many studies show that getting enough good quality sleep on a regular basis brings many health benefits. It protects against heart disease and diabetes, and perhaps against dementia as well. Sleep experts generally recommend an average of seven to eight hours of good quality sleep each night as the target to shoot for.
Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.