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Sleep and medical disorders.

Robert D Ballard1

  • 1National Jewish Medical and Research Center, 1400 Jackson Street, J201, Denver, CO 80206, USA. ballardr@njc.org

Primary Care
|June 7, 2005
PubMed
Summary

Sleep-disordered breathing, including obstructive sleep apnea (OSA), significantly impacts cardiovascular health and other conditions. Effective treatments like CPAP improve outcomes for patients with OSA and coexisting heart failure.

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Area of Science:

  • Cardiology
  • Pulmonology
  • Nephrology
  • Gastroenterology
  • Sleep Medicine

Background:

  • Sleep-disordered breathing (SDB) is prevalent in various chronic diseases, including cardiovascular disease, asthma, COPD, and end-stage renal disease.
  • Obstructive sleep apnea (OSA) negatively affects blood pressure, cardiovascular health, and mortality.
  • Conditions like congestive heart failure, asthma, COPD, and chronic dialysis are frequently associated with SDB, impacting disease severity and patient outcomes.

Purpose of the Study:

  • To review the link between sleep-disordered breathing and various chronic health conditions.
  • To highlight the impact of OSA on cardiovascular status and mortality.
  • To discuss therapeutic implications of SDB in patients with comorbid conditions.

Main Methods:

  • Literature review of studies linking sleep-disordered breathing with cardiovascular disease, asthma, COPD, GERD, and end-stage renal disease.
  • Analysis of the effects of OSA on physiological parameters and mortality.
  • Evaluation of therapeutic interventions for SDB in specific patient populations.

Main Results:

  • OSA adversely affects blood pressure, cardiovascular status, and mortality; CPAP therapy improves these parameters.
  • Congestive heart failure patients exhibit high prevalence of SDB (OSA 30%, Cheyne-Stokes 40%); CPAP is the preferred treatment.
  • Nocturnal asthma worsening may indicate increased severity and consideration of OSA; COPD patients often have impaired sleep due to hypoxemia; GERD during sleep can be a sequela of OSA.
  • End-stage renal disease and dialysis are associated with OSA, RLS, PLMD, and daytime sleepiness.

Conclusions:

  • Sleep-disordered breathing, particularly OSA, is a significant comorbidity across multiple chronic diseases, affecting cardiovascular health, respiratory function, and overall well-being.
  • Effective management of SDB, often with CPAP or other targeted therapies, is crucial for improving patient outcomes in conditions like heart failure, asthma, COPD, and renal disease.
  • Recognizing and treating SDB is essential for comprehensive patient care in the context of chronic illnesses.

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