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When to Suspect Sleep Apnea and What to Do About It
1Respiratory Division & Sleep Laboratory, McGill University Health Centre, Meakins-Christie Laboratories, Montreal, Québec, Canada.
The Canadian Journal of Cardiology
|June 27, 2015
Summary
Obstructive sleep apnea (OSA) is common in cardiovascular disease patients. Diagnosis via polysomnography or portable recorders aids treatment with positive airway pressure (PAP) devices to improve health outcomes.
Area of Science:
- Cardiology
- Sleep Medicine
- Pulmonology
Background:
- Obstructive sleep apnea (OSA) is highly prevalent in cardiovascular disease (CVD) patients.
- Symptoms like snoring and daytime sleepiness, and risk factors like obesity, suggest OSA.
- Congestive heart failure (CHF) patients may have OSA or central sleep apnea-Cheyne-Stokes respiration (CSA-CSR).
Purpose of the Study:
- To highlight the link between sleep apnea and cardiovascular disease.
- To outline diagnostic methods for sleep apnea in CVD patients.
- To discuss treatment objectives and options for improving patient outcomes.
Main Methods:
- Diagnostic evaluation using in-laboratory polysomnography (PSG) as the gold standard.
- Utilizing portable cardiorespiratory recorders for diagnosis in specific patient groups.
- Reviewing treatment efficacy of positive airway pressure (PAP) devices.
Main Results:
- OSA should be suspected in CVD patients with refractory hypertension, nocturnal angina, arrhythmias, or stroke.
- PSG is recommended for diagnosis in most CVD patients, while portable recorders are useful in select cases.
- Positive airway pressure (PAP) therapy is the primary treatment for OSA, with adaptive servoventilation effective for CSA-CSR.
Conclusions:
- Early consideration of OSA in cardiovascular patients is crucial.
- Objective sleep studies are essential for accurate diagnosis and management.
- Effective treatment of sleep apnea can improve cardiovascular health and quality of life.
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