A number of studies over the years have shown that there is a link between sleep apnea and an increased risk of some cardiovascular diseases such as heart attack and stroke. Indeed, in one study it was suggested that the presence of sleep apnea could double the risk of having a stroke.

One question that remains the subject of some debate though is whether each can cause the other. In other words, while it is well accepted that sleep apnea can cause cardiovascular problems, it is not quite so clear whether or not cardiovascular problems can lead to sleep apnea.

This question was raised again recently when French researchers discovered that a number of patients who had been fitted with pacemakers were subsequently found to be suffering from sleep apnea. The picture was clouded however because normal symptomatic testing did not reveal this fact and indeed showed that the group appeared to have no greater tendency towards sleep apnea than the population at large. However when the group was subjected to more detailed testing, and was monitored in a sleep laboratory using polysomnography, 37 percent of the group was found to have mild sleep apnea.

At this point more testing will be needed to determine the link between sleep apnea and the presence of a pacemaker and to establish the relationship between cause and effect. This in turn would effectively mean testing all of those patients fitted with a pacemaker which is both impractically and far too expensive. The first step therefore is to devise a simpler test for the presence of mild sleep apnea and work is currently underway in this area.

In practical terms however if, as many suggest, it is the presence of mild sleep apnea in some cases which is inducing irregular electrical activity in the heart, for which the pacemaker is being fitted, then treating the sleep apnea through such things as diet and exercise and using continuous positive airway pressure (CPAP) machines might well reduce the need in some patients for a pacemaker to be fitted at all.

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