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Peripheral Arterial Disease (PAD) and Sleep

Leg pain and other symptoms of peripheral arterial disease (PAD), which occur when narrowed blood vessels reduce the flow of blood to your limbs, can make it difficult to get enough sleep. So can certain sleep disorders that are linked to PAD.

PAD is mostly caused by atherosclerosis, which is when fats and other debris build up in your veins from your bloodstream. It usually affects the blood supply to your legs, but sometimes it involves your arms.

Treatment for PAD, and for any related conditions you may have, can help you get the rest you need.

What are the symptoms of PAD?

The symptoms of PAD, sometimes called peripheral arterial disease, can range from mild to severe. Some people with the disorder “may have no symptoms,” says Lee Kirksey, MD, a vascular surgeon at the Cleveland Clinic.

In other cases it causes problems such as:

Claudication. These are leg pains that you get when you exercise, usually in your calf muscles or thigh muscles. “Patients typically describe that when they walk a certain distance, they experience cramps, heaviness, or a charley horse,” Kirksey says. “When they rest, that discomfort … goes away, and when they walk a similar distance again, they will experience that discomfort again.”

Wounds and other pain. You can get sores or stomach ulcers on your toes and feet. You may also feel pain in your toes or the front of your foot, even when you are not active. “Those symptoms indicate that they are very serious peripheral arterial disease, ”Says Kirksey. People with these symptoms may also notice that their legs and feet are cool, pale or numb.

Tissue damage. Critical limb ischemia (CLI) is the most severe stage of PAD. This is when the blood flow to your limb is so restricted that sores do not heal. At this stage you run the risk of needing an amputation. You will need surgery to improve blood flow. Only about 1% -2% of people with PAD reach this stage. About 30% of them will need an amputation.

How does PAD affect your sleep?

Depending on how severe your PAD is, it can disrupt your sleep in three main ways:

Pain stops you. Light PAD will probably not affect your sleep. But with more severe peripheral artery, you have pain even when you are not moving around. This means it can occur at night and wake you up. Tingling in your foot or toes can also wake you up. Getting up, or hanging your legs over the side of your bed, helps because it forces blood to flow into your lower limbs.

Sleep apnea, a condition linked to PAD, disrupts your sleep. “There is a clear connection between (PAD) and obstructive sleep apnea, which is a sleep disorder where people have regular waking periods at night, “says Kirksey.” They have periods where they stop breathing or breathe very little. All those things are disruptive to their sleep. “Apnea is more common in people who are overweight, he says.

When you stop breathing for a moment due to apnea, your oxygen levels drop. It causes inflammation in your body that can affect your heart, blood vessels in your brain and the veins that lead to your legs and arms, he says. This leads to scarring in your veins, which can lead to blockages and PAD.

Restless legs syndrome, also linked to PAD, wakes you up. About 10% -20% of people with PAD also have this sleep disorder.

“Patients typically describe that they just cannot keep their legs still at night. And the movement of their legs usually wakes them up, “says Kirksey.” Peripheral arterial disease does not necessarily cause restless leg syndrome, but it is associated. “

What are the risks?

No matter how it happens, it is unhealthy to lose sleep over a long period of time. “Sleep deprivation is associated with coronary heart disease, heart failure, diabetes, an increased risk of heart attack, stroke and obesity, ”says Kirksey.

If severe leg pain keeps you awake, call your doctor. “It’s a medical urgency,” he says. “They should contact their medical provider and get a visit as soon as reasonably possible.”

Also book an appointment if restless legs often interrupt your sleep. “It can be associated with other neurological disorders, nerve diseases, diabetes and metabolic and electrolyte disorders,” says Kirksey.

If you have sleep apnea, it may be a good idea to ask your doctor if you are at risk for PAD, especially if you have family members who have had it.

What can you do to sleep better with PAD?

If you notice any symptoms of PAD, especially those that keep you awake at night, see your doctor as soon as possible. They can assess your situation and recommend treatment.

You may be able to control a mild case of PAD with exercise. Step is ideal.

Your doctor may recommend an exercise program under supervision. It usually consists of walking on a treadmill, under the supervision of a nurse or exercise or physical therapist. They will encourage you to continue even after you notice cramps in the legs (claudication).

“Most people’s tendency is to stop walking,” Kirksey says. “But the approach to supervised exercise suggests that they have to push through that discomfort. It helps the muscles to develop alternative pathways for blood flow. And that in turn is likely to lead to better sleep at night.”

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