Obstructive sleep apnea and cardiovascular disease and mortality: the argument for causality

There is solid evidence linking obstructive sleep apnea (OSA) to cardiovascular mortality. Although it has yet to be scientifically proven that OSA causes cardiovascular disease, many investigators consider it an independent cardiovascular risk factor. Its impact on the cardiovascular mortality risk of a given applicant varies depending upon the severity of the condition, compliance with treatment, and the applicant's specific cardiovascular milieu. This review is aimed at making mortality risk assessment more accurate by describing what is known of the physiologic mechanisms by which OSA may influence cardiovascular mortality and providing an appreciation for the magnitude of this risk. In doing so, an argument supporting OSA as a cause for cardiovascular disease and mortality emerges.