What’s a sleep medicine physician doing at a center that specializes in cardiovascular care? Spend a few minutes with Harneet Walia, M.D., and the connection becomes clear: Sleep health is crucial to maintaining or enhancing your heart health.
If you have trouble falling asleep, sleeping through the night, or staying awake during the day, you may be among the one-third of Americans estimated to have sleep disorders, according to Dr. Walia, who serves as medical director of Sleep Medicine and Continuous Improvement at Miami Cardiac & Vascular Institute.
If left untreated, Dr. Walia says, sleep disorders can lead to chronic fatigue, difficulty concentrating, excessive daytime sleepiness, poor quality of life and the inability to accomplish everyday tasks. They also trigger physiological changes that can affect the health of your heart. Dr. Walia spoke with Resource recently and explained why finding time for more ZZZs in your day isn’t just a luxury, it’s a necessity.
Resource: Dr. Walia, can you tell us some of the common disorders typically treated by a sleep medicine physician?
Dr. Walia: Of course. Sleep medicine encompasses a variety of disorders, including insomnia, sleep apnea, restless leg syndrome, parasomnia (walking or eating in your sleep or acting out of dreams), circadian rhythm disorders and many more. Because poor sleep can affect so many different aspects of your life and health, you see it being treated across a variety of specialties – pulmonary, psychiatry, neurology, ear-nose-throat, family medicine and more.
I happen to be part of the Cardiology Group at Miami Cardiac & Vascular Institute, a multidisciplinary team of top-tier physicians, advanced practice providers, medical assistants and clinical pharmacists who leverage our leading-edge treatments and technology to provide patients with the most advanced cardiovascular care.
Resource: What led you to specialize in sleep medicine?
Dr. Walia: The case that sparked my interest during my residency – and led to my research in the field and my degree – was a case involving resistant hypertension. The patient was on four different blood pressure medications but still was unable to bring it under control. A sleep study revealed that the patient had severe obstructive sleep apnea, which happens to be one of the leading cause of resistant hypertension. He was given continuous positive airway pressure (CPAP) therapy and quickly showed tangible improvement. I’ve also performed research that demonstrates how resolving sleep disorders can decrease symptoms of depression or insomnia in patients, and lead to a better quality of life overall.
Resource: How does someone know if they have sleep apnea?
Dr. Walia: If your partner complains about your loud snoring, or is alarmed when you seem to stop breathing for several seconds, you most likely have sleep apnea. Same thing if you have difficulty concentrating or staying awake during the day. Your primary care physician or specialist can refer you to a sleep medicine specialist. Or you can contact one of Baptist Health’s sleep centers directly to schedule an evaluation and sleep study, which can easily confirm whether or not you have sleep apnea.
Resource: What, typically, are the causes of sleep health issues – mental, physiological, or environmental? Or maybe all of the above?
Dr. Walia: All of the above, definitely. Insomnia is usually linked to stress, while obesity is a common comorbidity associated with sleep apnea. Restless leg syndrome can be associated with iron, and is also not uncommon during pregnancy, but many times there is no apparent cause. Some sleep disorders – sleep apnea, especially – tend to worsen with age. Over time, the tissue in our airway becomes softer and floppier, which increases the likelihood of snoring and obstructive sleep apnea. Also, many sleep disorders are hereditary, so if you have a family history, you should be aware of this and let your doctor know.
Resource:And this can affect your heart health?
Dr. Walia: Absolutely. Data suggests that people who get insufficient sleep or experience sleep deprivation are at a higher risk for cardiovascular disorders. We can actually measure the various physiological changes that occur in patients with sleep disorders. They include hypoxia (decreased oxygen levels); hypercapnia (excessive carbon dioxide in the bloodstream); changes in intrathoracic pressure; increased systemic inflammation, and increased activation of the sympathetic nervous system – meaning your body’s engine is always in high alert mode, just as when you’re faced with a dangerous or stressful situation. All of these can make you more prone to negative changes in your heart health.
Resource:How do you apply the science of sleep medicine to caring for a cardiac patient?
Dr. Walia: Sleep health is critical to a healthy life. Just as we talk about using diet and exercise to improve our overall health, we should also be talking about sleep as one of our pillars of health. At Miami Cardiac & Vascular Institute, we want to optimize the sleep health of every patient by screening for sleep disorders and making sure they’re getting adequate sleep – both in terms of quantity and quality.