A study is underway to try to understand why people with sleep apnoea are more likely to die from heart disease.
The research, being run by scientists at University of Warwick and University Hospitals Coventry and Warwickshire NHS Trust (UHCW), is monitoring the hearts of 100 patients.
It is being funded by the charity the British Heart Foundation (BHF), which is investing nearly £265,000 to carry out the research over three years.
According to the Sleep Apnoea Trust, as many as 10 million people in the UK suffer from the most common form of obstructive sleep apnoea (OSA), with up to four million of these suffering either severely or moderately.
OSA causes breathing to stop intermittently because to a blockage of the airways at night, which can cause excessive sleepiness in the day – something that can of course affect a person’s ability to work and will be especially important in safety-critical environments. It is also known to be associated with higher rates of illness and death linked to the heart.
The most common way to treat OSA is via a continuous positive-airways pressure (CPAP) machine, which pumps air into the mouth through a mask while you sleep.
Heart disease
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Although CPAP machines can improve sleep and means OSA sufferers feel less tired in the day, research has shown that using the machine doesn’t decrease the risk from heart disease.
Scientists now want to find out whether this is because patients with OSA are more likely to suffer from arrhythmias, including atrial fibrillation (AF).
Although AF on its own may not be dangerous, it can lead to an increased risk of stroke, heart failure or other heart-related problems if left undetected and untreated.
To study the link between OSA and AF, the scientists will monitor the heart rhythms of patients by implanting implantable loop recorders under their skin. They will also use other methods, including Holter monitors.
All participants in the trial will be treated using a CPAP machine as part of their usual care and the study will include a control group of another 100 patients, who will use the machine but not have their hearts monitored.
Lead researcher Professor Faizel Osman, consultant cardiologist and electrophysiologist at UHCW, said it was hoped that, by closely monitoring the hearts of their patients, they would be able to observe abnormal heart rhythms in a way that wouldn’t otherwise happen.
“We know that the pick-up rate for AF in patients with OSA is traditionally very low, but with this trial we’re planning to get, for the very first time in the world that I am aware of, an accurate idea of exactly what the prevalence rate is,” he said.
“We hope that by the end of the trial to know what the true rate of atrial fibrillation and other arrhythmias is in these patients and be able to prove that this is something that is happening to people with OSA but isn’t always discovered.
“This would mean that heart monitoring could become more routine for those at risk who present with OSA with the very real potential to save lives.”
The patients taking part in the trial, all living in the Coventry and Warwickshire area, have been chosen because they have obstructive sleep apnoea but, at the start of the trial at least, do not have any known heart rhythm problems.
Cardiac waiting lists at record high
Separately, BHF has responded to NHS England figures published earlier this month that showed the number of people on cardiac waiting lists had risen to a record high of 396,743 at the end of June, an increase of 4,045 people on the previous month.
The latest increase means the number of people on the waiting list has risen by 70% since February 2020, the month before the pandemic began, when 233,081 people were waiting for cardiac care.
There was a further rise in the number of people who were waiting more than four months (the maximum intended waiting time target) for potentially lifesaving heart care at the end of June, 147,241 compared with 141,030 at the end of May.
Well over a third (37%) of all people on waiting lists for cardiac care were waiting over 18 weeks for care. The longer people wait for treatment, the higher their risk of becoming disabled from heart failure or dying prematurely.
The number of people waiting more than a year for time-critical heart tests and treatments rose to 12,799, another record high. Just 28 people were waiting this long three years ago in February 2020.
Dr Sonya Babu-Narayan, BHF associate medical director, said: “It never fails to shock me that month after month, we continue to see record rises in the number of people waiting far too long for potentially lifesaving heart care in England.
“We need decisive action now to address this cardiovascular crisis by ensuring there will be enough skilled heart care staff working in suitable buildings with sufficient equipment,” she added.
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