Obstructive Sleep Apnea and Cardiovascular Disease: Where Do We Stand?

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.