Obstructive Sleep Apnea Increasingly Associated With Cardiovascular Disease

The study, which attributes the increased link between OSA and cardiovascular disease to heightened recognition and perhaps a rising prevalence, found mounting data suggesting a potentially important causative role of OSA in cardiovascular disease, particularly systemic hypertension, bolstered by well-described pathophysiologic responses to apnea and hypopneas. Recently published longitudinal cohort studies have strengthened previously recognized associations with stroke and mortality from cardiac events.

"There is abundant physiologic evidence implicating OSA in perpetuating, if not inticing, heart failure. In addition to their association with systemic hypertension, OSA-related stressors, including hypoxemia, increased sympathetic drive, acute surges in blood pressure, and mechanical effects of intrathoracic pressure swings, have varying effects on myocardial oxygen supply and demand, particularly in the already compromised heart," said Sean M. Caples, DO, of the Mayo Clinic College of Medicine in Rochester, Minn., one of the authors of the study.

According to Lawrence Epstein, MD, American Academy of Sleep Medicine (AASM) past president, medical director of Sleep HealthCenters and instructor of medicine at Harvard Medical School, treating sleep disorders and getting an adequate amount of sleep are pillars of good cardiovascular health.

"Sleep apnea is a known risk factor for the development of hypertension, heart disease and stroke," said Epstein. "Also, chronic sleep deprivation has been shown to change metabolic function in a way that promotes weight gain and diabetes, two risk factors for heart disease."

OSA, a sleep related breathing disorder that causes your body to stop breathing during sleep, occurs when the tissue in the back of the throat collapses and blocks the airway, which prevents air from getting into the lungs.

In addition to cardiovascular disease, other effects of OSA include daytime sleepiness, alertness and concentration deficiencies, and an increased risk of hypertension, stroke and diabetes.

OSA can occur in men and women of any age, but it is most common in obese, middle-aged men. The AASM estimates that four percent of men and two percent of women have OSA, and millions more remain undiagnosed.

Safe and effective treatments are available for those with OSA. Scientific evidence shows that continuous positive airway pressure (CPAP) is the best treatment for OSA. CPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open, preventing the pauses in breathing that characterize sleep apnea and restoring normal oxygen levels.

Dennis H. Nicholson, MD, medical director of the Sleep Disorders Center at Pomona Valley Hospital Medical Center in Pomona, Calif., says that more public education needs to be done in order to reach out to as many people as possible about cardiovascular disease, and notes that a good night's sleep is critical to maintaining good health.

"Public education is an important and often neglected component in the overall strategy to improve sleep, cardiovascular outcomes and general well being," said Nicholson, who added that reaching out to people about the importance of sleep may result in a decline in the number of reported cardiovascular diseases.

Those who think they might have OSA, or another sleep disorder, are urged to discuss their problem with their primary care physician, who will issue a referral to a sleep specialist.