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Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
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Obstructive sleep apnoea heterogeneity and cardiovascular disease
Susan Redline1,2, Ali Azarbarzin3,4, Yüksel Peker3,5,6,7,8
1Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA. sredline@bwh.harvard.edu.
Nature Reviews. Cardiology
|March 10, 2023
Summary
Obstructive sleep apnoea (OSA) is common in cardiovascular disease (CVD) patients. While CPAP treatment shows inconsistent results, OSA
Area of Science:
- Cardiology and Sleep Medicine
- Investigating the intricate relationship between sleep-disordered breathing and cardiovascular health.
Background:
- Obstructive sleep apnoea (OSA) is highly prevalent in patients with cardiovascular disease (CVD).
- Observational studies link OSA to increased risks of hypertension, stroke, myocardial infarction, heart failure, arrhythmias, and mortality.
- Clinical trials on continuous positive airway pressure (CPAP) for OSA have yielded inconsistent cardiovascular outcome improvements.
Purpose of the Study:
- To review the shared risk factors and causal links between OSA and CVD.
- To explore the heterogeneity of OSA, recognizing it as a complex disorder with various subtypes.
- To discuss emerging knowledge on mechanistic pathways and potential biomarkers for CVD risk stratification in OSA patients.
Main Methods:
- Review of existing observational studies and clinical trials on OSA and CVD.
- Analysis of factors contributing to OSA heterogeneity (anatomical, physiological, inflammatory, obesity-related).
- Exploration of novel biomarkers for assessing hypoxic burden and cardiac autonomic response in OSA.
Main Results:
- Despite observational links, CPAP treatment efficacy for cardiovascular outcomes in OSA remains inconsistent, possibly due to trial design and adherence issues.
- OSA is a heterogeneous disorder, with different subtypes arising from varied risk factors and leading to distinct physiological disturbances.
- Emerging biomarkers show promise in predicting OSA-related adverse health outcomes and treatment response.
Conclusions:
- Understanding OSA heterogeneity is crucial for elucidating varied mechanistic pathways linking OSA to CVD.
- Personalized approaches, potentially guided by novel biomarkers, may be necessary for effective CVD risk management in OSA patients.
- Further research is needed to refine OSA classification and optimize therapeutic strategies for cardiovascular health.
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