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Sleep-Disordered Breathing and Cardiac Arrhythmias
Tushar Menon1, Ikechukwu Ogbu1, Dinesh K Kalra1
1Division of Cardiology, Department of Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA.
Journal of Clinical Medicine
|November 27, 2024
Summary
Sleep-disordered breathing significantly increases the risk of cardiac arrhythmias, including atrial fibrillation and ventricular tachycardia. Continuous positive airway pressure (CPAP) therapy effectively reduces these risks, improving cardiovascular health.
Area of Science:
- Cardiology
- Sleep Medicine
- Pulmonology
Background:
- Sleep-disordered breathing (SDB) is increasingly recognized for its association with cardiovascular complications.
- Mechanistic links involve intermittent hypoxia, autonomic imbalance, and intrathoracic pressure swings.
Purpose of the Study:
- To review and synthesize the mechanistic links between SDB and cardiac arrhythmias.
- To evaluate the impact of SDB on various types of arrhythmias.
- To assess the efficacy of continuous positive airway pressure (CPAP) therapy in managing SDB-related arrhythmias.
Main Methods:
- A narrative review of peer-reviewed articles from major databases (PubMed, EMBASE, Scopus, Web of Science).
- Analysis of data from key trials like DREAM and CESAAR.
- Meta-analysis of findings related to SDB and arrhythmia risks, and CPAP efficacy.
Main Results:
- SDB more than doubles the risk of overall arrhythmias (OR 2.24) and quadruples the risk of atrial fibrillation (AF) (OR 4.02).
- SDB increases the risk of non-sustained ventricular tachycardia (NSVT) and bradyarrhythmias (OR 2.50).
- CPAP therapy significantly reduces AF recurrence (42%) and ventricular arrhythmia (VA) incidence (58%), and may decrease bradyarrhythmia occurrences.
Conclusions:
- SDB is a significant, modifiable risk factor for cardiac arrhythmias.
- Early diagnosis and management of SDB, particularly with CPAP, are crucial for improving cardiovascular outcomes.
- CPAP therapy demonstrates substantial benefits in mitigating SDB-associated cardiac electrical disturbances.
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