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Obstructive sleep apnea (OSA) is a growing social problem, particularly in well-developed countries. It has been demonstrated that obstructive sleep apnea is a significant risk factor for cardiovascular diseases, including arterial hypertension, ischemic heart disease, heart failure, rhythm/conduction disturbances, as well as cerebral stroke. The pathophysiology of these diseases is complex and multifactorial. We present the current state of research on behavioral and environmental factors that influence the relationship between OSA and cardiovascular changes. We discuss the relationship between obesity, alcohol, sedatives, environmental tobacco smoke, allergic diseases and environmental pollution on the one hand and OSA on the other. In this context, the environment should be considered as an important modulator of the relationship between OSA and cardiovascular diseases.

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A relationship between obstructive sleep apnea (OSA) and abnormalities in 24-h electrocardiogram (ECG) Holter monitoring has not been sufficiently documented. The aim of this study was to analyze the relation between the occurrence and the severity of OSA and the parameters of ECG Holter monitoring in a group of patients with diagnosed OSA. Ninety-four patients with clinical suspicion of OSA were qualified for the study (mean age 53.7). All participants underwent a medical history, laboratory tests, 24-h ECG Holter monitoring, and single-night video-polysomnography (vPSG) using the American Academy of Sleep Medicine recommendations. A group of patients with diagnosed OSA was characterized by more frequent occurrence of supraventricular tachycardia (SVT) and ventricular arrhythmias (VPC). A statistically significant positive correlation was shown between the apnea-hypopnea index (AHI) and average heart rate, supraventricular arrhythmias (SVPC) pairs, SVT, and pauses >2.5 s. In regression analysis, higher AHI constituted an independent predicator for the increased number of pauses >2.5 s, SVT, and SVPC pairs in 24-h ECG Holter monitoring. In summary, patients with OSA are characterized by the increased number of abnormalities in 24-h ECG Holter monitoring.

Obstructive sleep apnea (OSA) causes dysfunction of the autonomic nervous system, but the exact mechanism has not been fully understood. The aim of this study was to analyse the relationship between the incidence and severity of OSA and heart rate turbulence (HRT). Seventy one patients with clinical suspicion of OSA were qualified to participate in the study. All participants took part in a survey and were subjected to laboratory tests, 24-hour electrocardiogram (ECG) Holter monitoring with HRT analysis and polysomnography. The group with OSA manifested significantly higher turbulence onset (TO) and lower turbulence slope (TS) as compared to the group without OSA. Older age, diabetes, hypertension and higher apnea/hypopnea index (AHI) were found to be independent risk factors for increased TO, whereas older age, higher body mass index (BMI), higher blood glucose levels, hypertension and higher AHI were independent risk factors for TS reduction. The AHI ≥65 criterion indicates abnormal HRT in patients with OSA with 94.9% sensitivity and 50.0% specificity, which gives a prediction accuracy of 85.7%. In summary, OSA should be considered as a predictor of abnormal HRT.