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Area of Science:

  • Cardiology
  • Sleep Medicine
  • Pulmonology

Background:

  • Obstructive sleep apnea (OSA) is prevalent in cardiovascular disease (CVD) patients, with evidence suggesting an independent association.
  • While observational studies link OSA to CVD risk and positive airway pressure (PAP) to improved outcomes, recent trials show mixed results.

Approach:

  • This narrative review and position paper synthesizes current evidence on the OSA-CVD relationship.
  • It evaluates the prognostic value of the apnea-hypopnea index (AHI) and explores novel predictive markers.

Key Points:

  • The relationship between OSA and CVD risk factors appears bidirectional.
  • The AHI has limited prognostic value for CVD outcomes in OSA patients.
  • Novel markers of hypoxic burden and autonomic response may predict adverse CVD outcomes and treatment response.

Conclusions:

  • Health professionals need updated evidence to identify OSA patients most likely to benefit from treatment.
  • Optimizing OSA treatment and coexisting CVD management is crucial for improved patient outcomes.