Obstructive sleep apnea: a cardiopulmonary perspective and medical therapeutics

The clinical importance of obstructive sleep apnea (OSA) is gradually rising to the extent that many clinicians now consider OSA as an underlying etiology or precipitating factor for many cardiovascular and pulmonary events. Although the incidence and pathophysiology underlying these cardiopulmonary structural and functional abnormalities are not well defined, various mechanisms are hypothesized. These include but are not limited to sympathetic activation, oxidative stress, inflammation, and endothelial dysfunction. Given the rising awareness of OSA, it is timely to review the effects of OSA on cardiovascular complications like arrhythmias and ventricular remodeling. In the later part of the review, we focused on the role of therapeutics in the management of patients with OSA. Although the role of medical therapeutics is not well defined, we reviewed the available literature focusing on the available options, supporting evidence and their role in specific subgroup of patients with OSA.