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Sleep Breath. 2020 Jan 9. doi: 10.1007/s11325-019-01945-w. [Epub ahead of print]

Obstructive sleep apnea and cardiovascular disease, a story of confounders!

Author information

1
Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. jacob.collen@usuhs.edu.
2
Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
3
Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
4
Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
5
Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD, 20889, USA.

Abstract

Obstructive sleep apnea (OSA) syndrome is increasingly common among middle aged and older adults and is frequently linked to most cardiovascular diseases (CVD). Sleep-disordered breathing and CVD share a number of common risk factors and comorbid conditions including obesity, male gender, advancing age, metabolic syndrome, and hypertension. OSA appears to be associated with worsened CVD outcomes, sleep-related symptoms, quality of life, and risk of motor vehicle accidents. Demonstrating a cause-and-effect relationship between CVD and OSA has been challenging due to shared comorbidities. Strong evidence demonstrating clinically significant benefit for OSA treatments on OSA-related CVD outcomes are limited. In this review, we evaluate potential pathophysiologic mechanisms that link OSA to CVD and focus on specific treatments for OSA, including positive airway pressure (PAP), dental devices, and surgeries with regard to OSA-related CVD outcomes.

KEYWORDS:

Atrial fibrillation; Cardiovascular disease; Cerebrovascular accident; Cerebrovascular disease; Congestive heart failure; Continuous positive airway pressure; Coronary artery disease; Hypertension; Obstructive sleep apnea; Positive airway pressure; Pulmonary hypertension

PMID:
31919716
DOI:
10.1007/s11325-019-01945-w

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