Obstructive Sleep Apnea and Cardiovascular Morbidities: A Review Article

Abstract

In obstructive sleep apnea (OSA), there are brief episodes of partial or total upper airway obstruction during sleep, which leads to apnea or hypopneas. Much attention is required to understand OSA's effects on the human body, owing to how common but under-diagnosed this disorder remains. Though the role of OSA in cardiovascular (CV) disease is commonly discussed, it remains unclear how it induces changes in the human body. The intermittent and recurrent hypoxia occurring at the cellular level in this condition is critical for the dramatic changes observed. Vascular endothelial cell (VEC) injury and other mechanisms seen in OSA lead to changes in the CV system. OSA can take a toll on a person's overall functioning, especially with so much importance in today's time on preventing and treating cardiac-related deaths. A total of 31 published articles were included from the PubMed database for our literature review. Most of the studies showed a strong association of OSA with hypertension, especially resistant hypertension. Findings were consistent with OSA's independent role in causing CV diseases, included heart failure, coronary artery disease (cardiac ischemia), arrhythmias, and ischemic stroke. Continuous Positive Airway Pressure (CPAP) is one of the reliable and beneficial treatments for OSA patients. OSA is a treatable and modifiable risk factor for cardiac events and related deaths. The primary purpose of our review article was to address any existing gaps between OSA and its effect on the human body with particular emphasis on cardiovascular changes.

Screening for Primary Aldosteronism is Underutilized in Patients with Obstructive Sleep Apnea

“…18 Both patients with sleep apnea and those with primary aldosteronism are at increased risk for cardiovascular disease. [19][20][21][22] Although observational studies have shown continuous positive airway pressure use to be associated with improved cardiovascular outcomes in sleep apnea patients, an international, randomized controlled trial failed to demonstrate a reduction in cardiovascular events with continuous positive airway pressure use. 23 The authors hypothesized that this lack of efficacy may have been due to insufficient adherence.…”

Transcriptomic Changes of Murine Visceral Fat Exposed to Intermittent Hypoxia at Single Cell Resolution

“…Furthermore, upper airway anatomy and collapsibility remain a fundamentally important pathophysiological factor. However nonanatomical factors, such as impaired muscle responsiveness, low arousal threshold, high loop gain, rostral fluid shifts, lung volume, additionally play a variable role [ 55 , 56 ]. Recent focused studies in murine models and in humans indicate that IH mediates some of its detrimental effects through adipose tissue inflammation and dysfunction [ 1 , 20 , 28 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ].…”

Association of Retinal Vascular Manifestation and Obstructive Sleep Apnea (OSA): A Narrative Review

“…5 Moderate to severe forms of OSA (AHI ≥15) are prevalent amongst men and women aged between thirty-and 70-year old at percentages of 13% and 6%, respectively. 6…”