Sleep-disordered breathing increases the risk of arrhythmias

Sleep-disordered breathing (SDB) has been consistently associated with increased risk for cardiovascular diseases, including arrhythmias. The purpose of this review is to elucidate the several pathophysiologic pathways such as repetitive hypoxia and reoxygenation, increased oxidative stress, inflammation and sympathetic activation that may underlie the increased incidence of arrhythmias in SDB patients. We discuss in particular the incidence of ventricular arrhythmias, atrial fibrillation and bradyarrhythmias in SDB patients. In addition, we discuss the electrocardiographic alteration such as ST-T changes during apneic events and QT dispersion induced by SDB that may trigger complex ventricular arrhythmias and sudden cardiac death. Finally, we consider also the therapeutic interventions such as continuous positive airways pressure therapy, a standard treatment for SDB, that may reduce the incidence and recurrence of supraventricular and ventricular arrhythmias in patients with SDB.