Obstructive sleep apnea and cardiovascular disease - time to act!

Area of Science:

• Cardiology
• Sleep Medicine
• Pulmonology

Background:

• Sleep-related breathing disorders, particularly obstructive sleep apnoea (OSA), are prevalent and significantly disrupt sleep quality.
• Obesity, a primary risk factor for OSA, is increasingly common, suggesting a rise in OSA prevalence.
• OSA is recognized as a risk factor for hypertension, cardiovascular events, and metabolic disturbances like insulin resistance.

Purpose of the Study:

• To review the established and emerging evidence linking obstructive sleep apnoea (OSA) to cardiovascular and cerebrovascular diseases.
• To highlight the impact of OSA treatment, particularly continuous positive airway pressure (CPAP), on cardiovascular health.
• To underscore the importance of recognizing OSA as an independent risk factor for significant health conditions.

Main Methods:

• Review of randomized controlled trials (RCTs) and observational studies on OSA and its health consequences.
• Analysis of evidence supporting the efficacy of nasal continuous positive airway pressure (CPAP) in managing OSA-related complications.
• Synthesis of current understanding regarding OSA's role in hypertension, cardiovascular events, and cerebrovascular disease.

Main Results:

• Randomized controlled trials demonstrate that nasal CPAP treatment positively impacts arterial blood pressure.
• Evidence indicates that treating OSA can reduce the risk of fatal and non-fatal cardiovascular events.
• Beneficial effects of OSA treatment have been observed in patients with heart failure and heart rhythm disturbances.

Conclusions:

• Obstructive sleep apnoea (OSA) is an independent risk factor for hypertension and likely for cardiovascular and cerebrovascular diseases, not just daytime sleepiness.
• Effective treatments for OSA are available, challenging previous therapeutic nihilism.
• Further research is needed to identify specific patient subgroups that benefit most from OSA treatment.