Obstructive sleep apnoea as a risk factor for atherosclerosis - implication for preventive and personalised treatment

Area of Science:

• Cardiovascular Science
• Sleep Medicine
• Pathophysiology

Background:

• Atherosclerosis is a leading cause of death in industrialized nations, driven by complex genetic and environmental factors.
• Obstructive sleep apnea (OSA) is increasingly recognized as a significant, yet often overlooked, contributor to vascular pathologies.
• Existing research suggests a strong association between OSA and the development and progression of atherosclerosis.

Purpose of the Study:

• To review current epidemiological and clinical evidence linking obstructive sleep apnea (OSA) with atherosclerosis.
• To explore the potential pathophysiological mechanisms connecting OSA to vascular dysfunction and atherosclerosis.
• To discuss predictive biomarkers for cardiovascular risk in OSA patients and personalized treatment strategies.

Main Methods:

• Systematic review of epidemiological and clinical studies.
• Analysis of proposed mechanisms including intermittent hypoxia, oxidative stress, inflammation, and metabolic changes.
• Evaluation of continuous positive airway pressure (CPAP) therapy's vasoprotective effects.

Main Results:

• Growing evidence supports a link between OSA and increased risk of atherosclerosis and related cardiovascular diseases.
• Intermittent hypoxia in OSA may trigger oxidative stress, inflammation, and metabolic alterations, promoting endothelial dysfunction.
• Continuous positive airway pressure (CPAP) treatment demonstrates potential vasoprotective benefits in OSA patients.

Conclusions:

• Obstructive sleep apnea is a significant risk factor for atherosclerosis, mediated by complex pathophysiological pathways.
• Identifying biomarkers is crucial for stratifying cardiovascular risk in OSA patients.
• Personalized treatment approaches, including CPAP, are essential for managing cardiovascular complications associated with OSA.