Sleep-disordered breathing and the association with cardiovascular risk

Area of Science:

• Cardiology
• Sleep Medicine
• Pulmonology

Background:

• Breathing-related sleep disorders, especially obstructive sleep apnea (OSA), are frequently undiagnosed in patients with cardiovascular disease (CVD).
• Limited healthcare provider awareness of the OSA-CVD link contributes to underdiagnosis.
• Emerging evidence links apneic events during sleep to significant daytime hemodynamic alterations.

Purpose of the Study:

• To highlight the association between obstructive sleep apnea and cardiovascular disease.
• To emphasize the hemodynamic consequences of OSA in wakefulness.
• To advocate for the diagnosis and treatment of OSA in CVD patients.

Main Methods:

• Review of existing evidence on the association between obstructive sleep apnea and cardiovascular disease.
• Analysis of the pathophysiological mechanisms linking OSA to hemodynamic changes.
• Examination of treatment outcomes for OSA in patients with CVD.

Main Results:

• Obstructive sleep apnea leads to acute and chronic daytime hemodynamic changes, including elevated sympathetic tone, reduced cardiac output, and altered hormone regulation.
• OSA is linked to cardiovascular risk factors like obesity and hyperlipidemia, and is considered an independent risk factor for hypertension.
• OSA is implicated in the development of heart failure and stroke.
• Positive airway pressure treatment for OSA resolves apneic events and improves daytime blood pressure and left ventricular function in patients with hypertension and heart failure.

Conclusions:

• Obstructive sleep apnea is a significant, often overlooked, contributor to cardiovascular disease.
• Effective treatments for OSA exist and can mitigate adverse cardiovascular outcomes.
• Increased awareness and diagnosis of OSA are crucial for managing patients with cardiovascular disease.