Sleep apnea increases risk of heart attack, stroke in Tanzania

By Kizito Makoye

DAR ES SALAAM, Tanzania (AA) - Health experts in the East African country of Tanzania have sounded alarm on the rising sleep-related breathing disorders such as snoring and apnea, which, if left untreated, may double the risk of heart attack, stroke, or sudden death.

Obstructive sleep apnea (OSA), for instance, which affects overweight people, is a disorder in which breathing stops for several seconds during sleep because the tissue in the throat collapses, blocking the airways, medical experts said.

The condition, in which a person’s airway is repeatedly blocked during sleep, causes pauses in breathing, increases the risk of high blood pressure, coronary artery diseases, and congestive heart failure, said Hellen Sabuka, a senior epidemiologist at Shree Hindul Mandal Hospital in Dar es Salaam.

According to her, OSA develops when an obstructed upper airway causes repeated episodes of disrupted breathing during sleep, which can occur dozens of times per night, interrupting sleep and leaving the person scared.

“OSA can negatively affect the patient’s health and increase the risk of heart diseases and death,” she told Anadolu Agency.

Obesity, smoking, a large neck circumference, and family history are identified as risk factors by Sabuka, who advises people to exercise frequently, test if they feel ill, and seek treatment to avoid it.

“When treated, patients report better mood, improved quality of life, and work productivity,” she said.

- Constant struggle

Glory Joseph, a consultant physician and intervention cardiologist at Bugando Referral Medical Center in Mwanza, explained that sleep apnea activates the body’s “fight or flight” mechanism, reducing the amount of blood pumped to the heart.

Repeated episodes every night for a few years can deprive the heart of vital oxygen.

“Sleep apnea patients who are constantly woken at night have a poor quality of sleep and feel exhausted all day. They may also have poor cardiovascular health,” she said.

Joseph warned that untreated sleep apnea may raise the risk of dying from heart diseases by up to five times.

“We need to raise awareness about screening for and treating OSA, especially in patients with pre-existing cardiovascular risk factors,” she told Anadolu Agency.

According to her, sleep-related breathing disorders are associated with cardiovascular risks and symptoms like high blood pressure, increased glucose levels, and irregular heart rhythm.

Although snoring can be a key sign of obstructive sleep apnea, these health experts, however, said almost everyone snores at some point in their lives.

“Snoring can be normal and not cause concern,” Sabuka said, adding, "but when it becomes loud or is interrupted by pauses in breathing that is when we start to be concerned.”

She said unlike central sleep apnea, which occurs when the brain occasionally skips telling the body to breathe, obstructive sleep apnea is due to the obstructed airway by weak, heavy, or relaxed soft tissues.

“Very often, a patient will make an effort with her/his belly and chest to try to get the air in and out, but she/he will be unable to do so due to an obstruction in the upper airway. Often she/he may be aware of this struggle, but it can be very, very scary,” said Joseph.

Surprisingly, these experts said many Tanzanians, if not the majority, are unaware that they snore at night. They are also ignorant that they stop breathing during sleep unless the blockage is severe enough for them to wake up gasping and choking.

“When your partner stops breathing or gasps for air while sleeping, it is a warning that he or she needs medical attention,” Joseph said.

She said whenever a person stops breathing for a few seconds, the body's sympathetic nervous system activates and increases blood pressure.

While hypertension is not a symptom of a sleep issue in and of itself, experts believe it can be a warning sign when combined with other signals.

Sabuka said obstructive sleep apnea often affects obese people because the extra weight in the mouth, tongue and neck crushes soft tissues, making it harder to breathe easily without snoring.

“Weight loss can be the effective remedy to address this problem,” she suggested.

Rashid Kavishe is a business executive who works around 16 to 17 hours a day, darting between his office in the city center and his factory in the Gerezani area.

With his hectic work, Kavishe believes his eight-year snoring problem is the result of weariness and stress.

"My partner was complaining about vibration in my throat, but I never took it seriously because it didn't impact my sleep," Kavishe recalled.

However, when he began to have breathing pauses and occasionally choked as his airway collapsed, he recognized he needed to visit a doctor.

"I was diagnosed with a sleeping disorder. I've had treatment," he said, adding, "but it's too expensive."