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Area of Science:

  • Sleep Medicine
  • Cardiology
  • Pulmonology

Background:

  • Obstructive sleep apnea (OSA) is a prevalent sleep-disordered breathing condition.
  • OSA is recognized for its extensive pathophysiological effects across multiple organ systems.
  • Male sex and obesity are key factors influencing OSA incidence and severity.

Purpose of the Study:

  • To review the pathophysiological mechanisms linking OSA to cardiovascular diseases (CVD).
  • To explore the association between OSA and various CVDs, including hypertension, heart failure, and stroke.
  • To discuss the challenges in determining OSA's independent role in CVD, especially in the context of obesity.

Main Methods:

  • Literature review of studies investigating OSA and its cardiovascular implications.
  • Analysis of the apnea-ventilation cycle's effects on circulatory hemodynamics, autonomic function, and inflammatory processes.
  • Examination of epidemiological data and clinical trial outcomes regarding OSA and CVD prevalence.

Main Results:

  • The apnea-ventilation cycle in OSA adversely affects hemodynamics, autonomic balance, and inflammatory markers, contributing to cardiovascular risk.
  • OSA is associated with a spectrum of CVDs, including hypertension, congestive heart failure, atrial fibrillation, stroke, coronary artery disease, pulmonary hypertension, and metabolic syndrome.
  • The independent role of OSA in CVD is complex and often confounded by obesity, with conflicting study outcomes.

Conclusions:

  • There is a growing consensus on the direct role of OSA in the development of cardiovascular diseases.
  • While some studies suggest cardiovascular benefits from OSA treatment, further research is required for confirmation.
  • Understanding the intricate relationship between OSA, obesity, and CVD is crucial for effective patient management.