Obstructive Sleep Apnea-hypopnea Syndrome and Cardiovascular Diseases (original) (raw)
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Sleep-disordered breathing and cardiovascular disease
Sleep Medicine Reviews, 2005
Sleep-disordered breathing (SDB) describes a group of disorders characterised by abnormalities in the frequency and/or depth of breathing while asleep. The most common type is the obstructive sleep apnoea/hypopnoea syndrome (OSAHS); it affects 2-4% of the adult population and is an independent risk factor for hypertension. Another type is central sleep apnoea (CSA), which includes Cheyne-Stokes respiration; it is most commonly seen in patients with congestive heart failure and other critical illnesses including cerebrovascular accidents. There is accumulating evidence that both these types of SDB are associated with cardiac failure, arrhythmias and coronary artery disease. Treatment of OSAHS with continuous positive airway pressure (CPAP) has lowered blood pressure, reduced the frequency and severity of some arrhythmias, and improved markers of endovascular inflammation. CPAP has had a mild positive effect on left ventricular function in chronic heart failure by treating co-existent SDB, but it has not improved mortality, possibly because it does not fully treat associated CSA. Clinicians need to be aware of the increasing associations of SDB, especially OSAHS, with cardiovascular dysfunction, as treatment of co-existent SDB will not only improve sleepiness, quality of life, and driving risk, but there is growing evidence that it may also improve cardiovascular risk itself, even in non-sleepy subjects.
Obstructive sleep apnea/hypopnea and systemic hypertension
Sleep Medicine Reviews, 2009
Obstructive sleep apnea/hypopnea (OSAH) syndrome is a highly prevalent condition. Severe OSAH affects 2-6% of the population, although only 10% of subjects are correctly diagnosed and treated. OSAH is an important and unresolved public health care problem because of its role in the development of cardiovascular events, negative impact on quality of life, and as a cause of traffic accidents. Longitudinal and cross-sectional studies have shown a strong association between OSAH and hypertension. Moreover, a number of open-label studies, the majority of 21 controlled studies included in the present review, a systematic review, and 4 recent meta-analyses have shown a reduction of blood pressure (BP) of about 2 mm Hg with continuous positive airway pressure (CPAP). This lowering of blood pressure is significant in terms of reduction of both cardiovascular and cerebrovascular risk and death. The effect is greater in hypertensive subjects and in those with more severe OSAH. Accordingly, treatment with CPAP could be considered in patients with severe OSAH and hypertension even in the absence of symptoms. The challenge to researchers is to find markers for discriminating subjects in whom blood pressure will decrease from non-responders. This will help to refine relevant clinical indicators for CPAP treatment in clinical practice.
Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS): Review of the Literature
https://www.ijrrjournal.com/IJRR\_Vol.9\_Issue.5\_May2022/IJRR-Abstract020.html, 2022
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common chronic sleep disorder. As the incidence of OSAHS increases, it has seriously threatened people's health. It causes significant morbidity and mortality in both developed and developing countries around the world. However, clinical trials of OSAHS have heterogeneous outcomes, surrogate outcomes, subjective outcomes, composite outcomes, and a lack of endpoints or patient perspectives. The diagnosis is confirmed by a sleep study. The main treatment for OSAS is the use of continuous positive airway pressure (CPAP) at night via a nasal or oronasal mask, which usually results in rapid improvement of symptoms. Patients who cannot tolerate CPAP therapy can be successfully treated with a mandibular advancement device. Supportive measures include regular and sufficiently long sleep periods, refraining from smoking and alcohol consumption in the evening, and weight reduction in overweight patients.
disease Sleep-disordered breathing and cardiovascular
2010
Sleep-disordered breathing (SDB) describes a group of disorders characterised by abnormalities in the frequency and/or depth of breathing while asleep. The most common type is the obstructive sleep apnoea/hypopnoea syndrome (OSAHS); it affects 2-4% of the adult population and is an independent risk factor for hypertension. Another type is central sleep apnoea (CSA), which includes Cheyne-Stokes respiration; it is most commonly seen in patients with congestive heart failure and other critical illnesses including cerebrovascular accidents. There is accumulating evidence that both these types of SDB are associated with cardiac failure, arrhythmias and coronary artery disease. Treatment of OSAHS with continuous positive airway pressure (CPAP) has lowered blood pressure, reduced the frequency and severity of some arrhythmias, and improved markers of endovascular inflammation. CPAP has had a mild positive effect on left ventricular function in chronic heart failure by treating co-existent SDB, but it has not improved mortality, possibly because it does not fully treat associated CSA. Clinicians need to be aware of the increasing associations of SDB, especially OSAHS, with cardiovascular dysfunction, as treatment of co-existent SDB will not only improve sleepiness, quality of life, and driving risk, but there is growing evidence that it may also improve cardiovascular risk itself, even in non-sleepy subjects.
Obstructive sleep apnea and cardiovascular disease
Journal of the American College of Cardiology, 2003
Obstructive sleep apnea (OSA) is a common disorder associated with an increased risk of cardiovascular disease and stroke. As it is strongly associated with known cardiovascular risk factors, including obesity, insulin resistance, and dyslipidemia, OSA is an independent risk factor for hypertension and has also been implicated in the pathogenesis of congestive cardiac failure, pulmonary hypertension, arrhythmias, and atherosclerosis. Obesity is strongly linked to an increased risk of OSA, and weight loss can reduce the severity of OSA. The current standard treatment for OSA-nasal continuous positive airway pressure (CPAP)-eliminates apnea and the ensuing acute hemodynamic changes during sleep. Long-term CPAP treatment studies have shown a reduction in nocturnal cardiac ischemic episodes and improvements in daytime blood pressure levels and left ventricular function. Despite the availability of effective therapy, OSA remains an underdiagnosed and undertreated condition. A lack of physician awareness is one of the primary reasons for this deficit in diagnosis and treatment.
Obstructive sleep apnea, hypertension and cardiovascular diseases
Journal of Human Hypertension, 2015
Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial (hypopnea) or complete interruption (apnea) in breathing during sleep due to airway collapse in the pharyngeal region. OSA and its cardiovascular consequences have been widely explored in observational and prospective studies. Most evidence verifies the positive relationship between OSA and hypertension, coronary artery disease, atrial fibrillation, stroke and heart failure. However, more studies are needed to better assess the impact of OSA, and possible benefit of treatment with continuous positive airway pressure (CPAP) on dyslipidemia, type 2 diabetes, insulin resistance and cardiovascular mortality. The leading pathophysiological mechanisms involved in the changes triggered by OSA, include intermittent hypoxemia and re-oxygenation, arousals and changes in intrathoracic pressure. Hypertension is strongly related with activation of the sympathetic nervous system, stimulation of the renin-angiotensin-aldosterone system and impairment of endothelial function. The high prevalence of OSA in the general population, hypertensive patients and especially obese individuals and patients resistant to antihypertensive therapy, highlights the need for effective screening, diagnosis and treatment of OSA to decrease cardiovascular risk.
Noninvasive Mechanical Ventilation, 2010
Obstructive sleep apnea (OSA) is a form of sleep-disordered breathing (SDB) that is characterized by intermittent complete or partial collapse of the upper airway. This pattern of breathing has been considered a cause for several cardiovascular diseases, such as systemic hypertension, heart failure, arrhythmias, myocardial infarction, and pulmonary hypertension. The prevalence of OSA in the middle-aged population was first estimated in 1993 by the ongoing population-based Wisconsin Sleep Cohort Study [1] in a sample of 625 employed adults. The investigators found that 9% of women and 24% of men had at least five or more apneas or hypopneas per hour of sleep . When the presence of extreme daytime sleepiness was included as a criterion, the prevalence was estimated to be 2% in women and 4% in men [1]. The incidence of SDB is independently influenced by age, sex, waist-hip ratio, and body mass index (BMI). The correlation between OSA and cardiovascular diseases has been well studied, and a linear relationship between severity of OSA and the comorbidities has been reported [2, 3]. The famous Sleep Heart Health Study revealed that the relative odds of heart failure, stroke, and coronary artery disease (CAD) (upper vs. lower apnea-hypopnea index [AHI] quartile) were 2.38, 1.58, and 1.27, respectively . In this chapter, we review the best-available evidence supporting the use of continuous positive airway pressure (CPAP) in OSA patients with hypertension, CAD, heart failure, pulmonary hypertension, and stroke.
Obstructive sleep apnea as a risk factor for cardiovascular diseases
Cardiology journal, 2007
Obstructive sleep apnea (OSA) is a common medical condition that occurs in approximately 5% to 15% of the population. It is usually associated with an increased risk of cardiovascular disease. Diagnosis of OSA is based on polysomnography, and its severity is measured with an apnea-hypopnea index. Most of the adverse effects of OSA on the cardiovascular system are reversible with treatment. In addition to continous positive airway pressure therapy, precautions such as weight loss, avoidance of central nervous system depressants, treatment of nasal congestion and sleeping in the lateral position may help to treat OSA. (Cardiol J 2007; 14: 534-537).
Obstructive sleep apnoea(OSA) is a common but under reported disease, especially of the obese population. The resulting apneic and hypopneic events during sleep result in sympathetic activation 1-4 which even persists during the day 5 and lead to various complications, especially in the cardiovascular system. A lot of emphasis is laid on the AHI values demonstrating linearity between elevated AHI and likelihood of adverse effects. However AHI does not capture significant aspects such as degree of oxygen desaturation, nocturnal hypoventilation or associated sleep disturbance. In our study we look at the degree of oxygen desaturation with rising AHI values. This observational study was conducted on patients presenting to the OPD of Sir Sunder Lal Hospital with symptoms of sleep disordered breathing. 50 patients were included in the study between