I came across a post in KevinMD with stories from women (many in their 30s and 40s) who suffered from serious heart attacks. I commented on this post in #5. I strongly urge you to read the entire article. I’ve also posted my reply below:
Wow! I was riveted while I read through the entire post. We know that younger women can have heart attacks, and it’s acknowledged that doctors are not good at picking up heart attack symptoms in younger women.
Here are a few observations that I had:
1. Many of the women had heart attacks from 3-5 AM. One study showed that people with obstructive sleep apnea have heart attacks during this timeframe, as compared to earlier in the morning in people who don’t have sleep apnea and have heart attacks.
2. Many women also described severe heartburn as a major symptom. If these women were having a sudden increase in the number and severity of apneas, then it’s expected to have more severe reflux, due to the negative pressures in the chest. One woman, Lidia, had too much to eat and drink for her birthday. Alcohol relaxes your throat muscles, and additional reflux from stomach juices can cause more obstructions and arousals.
3. One woman described recent 10 pounds weight gain—an additional risk for obstructive sleep apnea.
4. Also notice how many women either were pregnant or post-partum. Weight gain during pregnancy is a major risk for obstructive sleep apnea, which can lead to pre-eclampsia and gestational diabetes. That’s also why pregnancy complications are linked to a higher rate of heart disease—because you’re at risk for having obstructive sleep apnea. Post-partum, the protective effect of progesterone is gone (progesterone tenses your upper airway dilators), and more frequent breathing pauses can tip you over the edge.
5. I’m willing to bet that many of these women snored, but it’s also been shown that you can be young, thin and not snore to have significant obstructive sleep apnea. What I’m sure of is that one or both parents of these women snores heavily, with major cardiovascular disease. Typically, these women won’t be able to sleep on their backs, due to smaller oral cavity jaw structures, which narrows the posterior airway space. Deep sleep will relax the muscles, making them more prone to breathing pauses.
6. Some of the women also mentioned casually that they were sleep deprived. Not sleeping enough can be a major trigger to cause major sympathetic stimulation when normally, you’re not ever able to get efficient sleep at all.
7. I bet that most of these women, even when younger, never felt refreshed, no matter how long they slept. Typically, these women will attribute their fatigue to anemia, stress, TMJ, sinus infections, migraines, hypothyroidism, insomnia or chronic fatigue. Many will also have cold hands or feet, and oftentimes, blood pressure will be one the low side, especially when younger (later on, the BP normalizes and then goes high). This is called upper airway resistance syndrome, a variation of obstructive sleep apnea, where you can stop breathing 10 to 20 times per hours and not have official sleep apnea on a sleep study.
It’s important to pick up the atypical symptoms of heart attack in women, but what’s just as important is to treat what’s actually aggravating, if not causing the heart disease. If this had been done months or years prior to their heart attacks, many of these cardiac events could have been prevented.
In these women, there was usually some trigger that tipped them over the edge, whether it’s weight gain, eating late, severe stress, drinking alcohol, pregnancy, or even weather changes. There’s so much proven evidence showing that most people with heart disease have (or will have) significant obstructive sleep apnea. Physicians have to erase the image of the traditional sleep apnea patient as being overweight, snoring, male, with a big neck. Sleep apnea is a craniofacial, anatomic problem due to smaller jaws. Obesity comes later, which only makes the problem worse.