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Obstructive sleep apnea and cardiovascular disease, a story of confounders!

Jacob Collen1, Christopher Lettieri2, Emerson Wickwire3,4

  • 1Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. jacob.collen@usuhs.edu.

Sleep & Breathing = Schlaf & Atmung
|January 11, 2020
PubMed

Insights

Obstructive sleep apnea (OSA) is common in older adults and linked to cardiovascular disease (CVD). This review examines OSA

Area of Science:

  • Cardiology
  • Sleep Medicine
  • Public Health

Background:

  • Obstructive sleep apnea (OSA) is increasingly prevalent in middle-aged and older adults.
  • OSA is frequently associated with cardiovascular diseases (CVD), sharing risk factors like obesity, hypertension, and metabolic syndrome.
  • The causal link between OSA and CVD is complex due to shared comorbidities, and evidence for treatment benefits on CVD outcomes is limited.

Purpose of the Study:

  • To evaluate the pathophysiologic mechanisms linking OSA to CVD.
  • To review the impact of specific OSA treatments on CVD outcomes.

Main Methods:

  • Literature review focusing on the relationship between OSA and CVD.
  • Analysis of pathophysiologic pathways connecting OSA and cardiovascular health.
  • Evaluation of evidence for OSA treatments (PAP, dental devices, surgery) on CVD outcomes.

Main Results:

  • Shared risk factors complicate establishing a direct causal relationship between OSA and CVD.
  • OSA is linked to poorer CVD outcomes, reduced quality of life, and increased accident risk.
  • Limited robust evidence currently demonstrates significant CVD outcome improvements with OSA treatments.

Conclusions:

  • Understanding the pathophysiologic links between OSA and CVD is crucial.
  • Further research is needed to clarify the clinical benefits of OSA interventions on cardiovascular health.
  • Effective OSA management may play a role in mitigating CVD risks.

Keywords:
Atrial fibrillationCardiovascular diseaseCerebrovascular accidentCerebrovascular diseaseCongestive heart failureContinuous positive airway pressureCoronary artery diseaseHypertensionObstructive sleep apneaPositive airway pressurePulmonary hypertension

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