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Sleep apnea and cardiovascular disease

Alexander G Logan1, T Douglas Bradley

  • 1Mount Sinai Hospital, 435-600 University Avenue, Toronto, ON, M5G 1X5, Canada. logan@lunenfeld.ca

Current Hypertension Reports
|April 29, 2010
PubMed

Insights

Cardiovascular disease remains a leading cause of death. While sleep apnea is common in these patients, its long-term benefits and ideal treatments require further study through randomized controlled trials.

Area of Science:

  • Cardiology
  • Sleep Medicine
  • Public Health

Background:

  • Cardiovascular disease (CVD) is the primary cause of mortality in North America.
  • Sleep apnea affects roughly 50% of CVD patients, elevating their cardiovascular risk.
  • Current treatments like continuous positive airway pressure (CPAP) show short-term benefits, but long-term advantages are unclear.

Purpose of the Study:

  • To evaluate the necessity of identifying new treatable conditions for improving cardiovascular disease outcomes.
  • To assess the role of sleep apnea in cardiovascular disease and the efficacy of its treatments.

Main Methods:

  • Review of current understanding of sleep apnea in cardiovascular disease.
  • Discussion of existing treatments (CPAP) and emerging alternatives (adaptive servo-ventilation).
  • Emphasis on the need for randomized controlled trials (RCTs) to establish long-term benefits.

Main Results:

  • The long-term benefits of continuous positive airway pressure for cardiovascular disease remain elusive.
  • Alternative treatments for central sleep apnea are under investigation.
  • Evidence is insufficient to recommend routine sleep apnea screening or treatment for asymptomatic cardiovascular disease patients.

Conclusions:

  • Randomized controlled trials are essential to determine if treating sleep apnea improves survival and reduces cardiovascular disease risk.
  • Current evidence does not support routine screening for sleep apnea in cardiovascular disease risk assessment.
  • Treatment of sleep apnea is not currently recommended for preventing or managing cardiovascular disease in asymptomatic individuals.

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