[Should cardiologist routinely screen and evaluate patients for sleep disordered breathing?]

Area of Science:

• Cardiology
• Sleep Medicine
• Internal Medicine

Background:

• Obstructive sleep apnea (OSA) is increasingly recognized as a significant contributor to cardiovascular morbidity.
• Uncontrolled hypertension, arrhythmias, and heart failure symptoms can be exacerbated by undiagnosed sleep-disordered breathing.

Observation:

• A 61-year-old male presented with symptoms including reduced exercise capacity, dyspnea, edema, irregular heart rhythm, snoring, and hypertension.
• Diagnostic workup revealed severe obstructive sleep apnea (OSA) and atrial fibrillation with significant pauses on ECG Holter monitoring.

Findings:

• Continuous positive airway pressure (CPAP) therapy led to a marked reduction in the apnea-hypopnea index (from 31.6/h to 5.1/h).
• Following CPAP treatment, the patient experienced improved control of hypertension and heart failure, alongside a reduced cardiovascular risk profile.

Implications:

• This case highlights the critical need for cardiologists to routinely screen patients, particularly those with obesity, hypertension, or arrhythmias, for sleep-disordered breathing.
• Early diagnosis and management of OSA with CPAP can significantly mitigate cardiovascular risk and improve patient outcomes.