Sleep Apnea: The Slept-Upon Cardiovascular Risk Factor

Area of Science:

• Cardiology
• Sleep Medicine
• Internal Medicine

Background:

• Obstructive sleep apnea (OSA) affects over 936 million adults globally and is highly prevalent in cardiovascular patients (40-80%).
• OSA is linked to a doubled risk of cardiovascular disease, stroke, and mortality.
• Continuous positive airway pressure (CPAP) therapy targets OSA mechanisms and improves cardiovascular markers.

Purpose of the Study:

• To review the cardiovascular burden and mechanisms of OSA.
• To summarize the effects of CPAP on cardiovascular outcomes.
• To provide an overview of current evidence on OSA and cardiovascular health.

Main Methods:

• Conducted a narrative review of recent studies, meta-analyses, and trials.
• Searched major medical databases (PubMed, Embase, Cochrane).
• Focused on OSA pathophysiology, cardiovascular risks, and CPAP's impact.

Main Results:

• Intermittent hypoxia and sleep fragmentation in OSA drive cardiovascular issues via sympathetic activation, inflammation, and oxidative stress.
• Higher OSA severity correlates with increased cardiovascular risk, including atrial fibrillation and heart failure.
• CPAP improves oxygen levels, blood pressure, and cardiac function, with benefits seen in adherent patients.

Conclusions:

• OSA is a significant, modifiable cardiovascular disease risk factor.
• Screening for OSA should be routine in cardiology, particularly for resistant hypertension, atrial fibrillation, and heart failure.
• Adherence-focused CPAP therapy is crucial for realizing clinical cardiovascular benefits.