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Obstructive Sleep Apnoea and Heart Health
When we think about protecting our heart, most of us tend to focus on diet, regular exercise and blood cholesterol levels. However, one important yet overlooked factor is a good night’s sleep, which plays a vital role in maintaining heart health.
Mr Tan, a 52-year-old sales manager, had been snoring loudly for years. His wife often complained that his snoring kept her awake, but he dismissed it as “normal”. Over time, he began to feel increasingly tired during the day. A routine health screening later revealed that he had high blood pressure. A subsequent sleep study diagnosed him with Obstructive Sleep Apnoea (OSA) — a condition where breathing repeatedly stops during sleep.
Mr Tan’s story is not uncommon. In Singapore, studies suggest that up to 30% of adults may have moderate to severe sleep apnoea, with many cases remaining undiagnosed.
Why is sleep important for your heart?
Sleep is the period when the body repairs and resets itself. When sleep is poor, especially from conditions like OSA, it can lead to:
❤ High blood pressure
❤ Increased risk of heart attack and stroke
❤ Irregular heart rhythms
Obstructive Sleep Apnoea occurs when the airway narrows or becomes blocked during sleep, leading to repeated drops in oxygen levels. These repeated interruptions place stress on the heart and blood vessels. Over time, this ongoing strain can contribute to the development of long-term cardiovascular disease.
When is snoring a problem?
Many people assume that snoring is normal, or even a sign of deep sleep. While not all snoring is dangerous, the following warning signs suggest that you might need to seek medical attention:
❤ Loud and persistent snoring
❤ Choking and gasping for air during sleep
❤ Excessive fatigue or brain fog despite sufficient sleep
Who is at risk of obstructive sleep apnoea?
Although it is often associated with obesity, OSA is not limited to overweight individuals. In Asian populations, including Singapore, anatomical features such as having a smaller chin or jaw can also be a risk factor.
Other risk factors include:
❤ Male
❤ Middle aged
❤ Loud
❤ Family history of sleep apnoea
More treatment options available
The encouraging reality is that sleep disorders are highly treatable and there is no single approach that works for everyone.
The most widely known treatment is Continuous Positive Airway Pressure (CPAP) therapy, which uses a mask to keep the airway open during sleep. While highly effective, some patients — estimated at 30 to 50% — may find it difficult to tolerate.
Fortunately, there are several alternative options. Depending on the individual’s needs, sleep or Ear, Nose and Throat (ENT) specialist doctors may recommend:
❤ Surgical procedures to improve the airway structure
❤ Mandibular advancement devices that reposition the jaw during sleep
❤ Positional therapy, such as side-sleeping techniques
❤ Weight management strategies including diet, exercise, medication or weight loss surgery
More recently, newer therapies such as the hypoglossal nerve stimulation implant therapy, which is currently available in Singapore, have provided additional options for suitable patients. This implant helps move the tongue and soft palate forward during sleep, opening the airway. It has shown promising results and is increasingly considered, especially for those who are unable to tolerate CPAP.
A reminder: Sleep is part of caring for your heart
Taking care of your heart is not only about what happens during the day, but also about the quality of your sleep at night. Once treated, many patients have described it as ‘getting their life back’— feeling more alert, more productive and more present with their families.
More importantly, help is available and effective treatment can be tailored to each individual. Even if one option is not suitable, others can be explored. Early detection and treatment can significantly improve sleep quality and reduce long-term health risks.
By recognising the importance of sleep and seeking help when needed, everyone can take a powerful step towards better heart health and a better quality of life.
The article is contributed by Dr Phua Chu Qin, Senior Consultant, Department of Otorhinolaryngology – Head & Neck Surgery at Sengkang General Hospital.
