Obstructive Sleep Apnoea Syndrome: Continuous Positive Airway Pressure Therapy for Prevention of Cardiovascular Risk

Resano-Barrio, María Pilar; Arroyo-Espliguero, Ramón; Viana-Llamas, María C; Mediano, Olga

doi:10.15420/ecr.2020.10

Cited by 12 publications

(13 citation statements)

References 63 publications

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“…There is consistent evidence in epidemiological studies that there are higher cardiovascular -related morbidity and mortality rates in patients with severe untreated OSA than in patients on CPAP or patients who do not have severe OSA. 126 However, one major limitation of nonrandomized studies of CPAP treatment is that patients who are nonadherent to CPAP therapy may also be noncompliant with other aspects of chronic disease management. 127,128 Recent large -scale randomized CPAP studies have attempted to define the benefits of CPAP, but adherence has been a universal stumbling block.…”

Section: Mechanisms Of Cardiovascular Disease In Obstructivementioning

confidence: 99%

Cardiovascular manifestations in obstructive sleep apnea: current evidence and potential mechanisms

O’Donnell¹,

O'Mahony²,

McNicholas³

et al. 2021

Polish Archives of Internal Medicine

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as nonrestorative sleep and excessive daytime sleepiness (EDS). 7,8In addition to EDS, OSA is associated with reduced quality of life, poor cognitive function, and road traffic accidents, independent of age or sex. 9 -11 The principal morbidity and mortality of the condition, however, are due to the increased risk of the development and progression of numerous CVDs. 4 A large body of evidence has accumulated to date strengthening the association between OSA and CVD, with increased risk persisting after correction for common cardiovascular risk factors. 12 Obstructive sleep apnea is associated with increased incidence of systemic arterial hypertension, coronary artery disease, congestive cardiac failure, and stroke, 4,13,14 and although Introduction Obstructive sleep apnea (OSA) is a growing public health problem. 1 The prevalence of the disorder has been increasing rapidly over the last 2 decades in line with the obesity epidemic in the developed world. 2-4 It is estimated that OSA affects nearly 1 billion people worldwide. However, a significant proportion of patients remain undiagnosed, 5 with one estimate suggesting that more than 30 million people are undiagnosed in Europe alone. 1 There is a male to female predominance of 2 to 1, and OSA is more common in the middle -aged and elderly population. 6 Obstructive sleep apnea is characterized by recurrent partial or complete upper airway collapse during sleep leading to intermittent hypoxia (IH) and recurrent arousals culminating in disrupted sleep quality that typically manifests

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Section: Mechanisms Of Cardiovascular Disease In Obstructivementioning

confidence: 99%

Cardiovascular manifestations in obstructive sleep apnea: current evidence and potential mechanisms

O’Donnell¹,

O'Mahony²,

McNicholas³

et al. 2021

Polish Archives of Internal Medicine

View full text Add to dashboard Cite

show abstract

“…42 Possible reasons for this lack of benefit in the primary outcome include the overall low adherence to CPAP therapy, the inclusion of patients with low levels of symptoms or a heterogeneous pool of patients with different disease phenotypes and arterial oxygen desaturation and the potential lack of efficacy of CPAP in reducing recurrent cardiovascular events in patients with advanced or symptomatic atherosclerotic vascular disease. [43][44][45] The 2017 AHA/ACC guidelines on HF identified CPAP therapy as a reasonable treatment strategy (class IIb) to improve sleep quality and daytime sleepiness in patients with CVD and OSA. 46 Furthermore, CPAP therapy has beneficial haemodynamic effects, such as diminished systemic venous return, right ventricular preload and left ventricular afterload, as well as improved pulmonary total vascular resistance and ventricular diastolic function.…”

Section: Treatment and Referralmentioning

confidence: 99%

Asian Pacific Society of Cardiology Consensus Statements on the Diagnosis and Management of Obstructive Sleep Apnoea in Patients with Cardiovascular Disease

et al. 2022

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Obstructive sleep apnoea (OSA) is strongly associated with cardiovascular disease (CVD). However, evidence supporting this association in the Asian population is scarce. Given the differences in the epidemiology of CVD and cardiovascular risk factors, as well as differences in the availability of healthcare resources between Asian and Western countries, an Asian Pacific Society of Cardiology (APSC) working group developed consensus recommendations on the management of OSA in patients with CVD in the Asia-Pacific region. The APSC expert panel reviewed and appraised the available evidence using the Grading of Recommendations Assessment, Development, and Evaluation system. Consensus recommendations were developed and put to an online vote. Consensus was reached when 80% of votes for a given recommendation were in support of ‘agree’ or ‘neutral.’ The resulting statements provide guidance on the assessment and treatment of OSA in patients with CVD in the Asia-Pacific region. The APSC hopes for these recommendations to pave the way for screening, early diagnosis and treatment of OSA in the Asia-Pacific region.

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“…HF is a major health issue with an increasing incidence, a high rate of hospitalizations, and high mortality in developing countries. Focusing on early recognition and management of HF comorbidities may have an important role in reducing the economic burden and public health impact of HF (5).…”

Section: Csa and Hfmentioning

confidence: 99%

“…The early recognition and treatment of sleep apnea are important for the improvement of quality of life (QoL) and prevention of the earlier-mentioned consequences. The diagnosis of SDB implies testing during sleep, including laboratory polysomnography (PSG) or home sleep apnea testing (5). The association between HF, sleep apnea, and rhythm disturbances has been analyzed, revealing the coexistence of these pathologies in >50% of affected individuals (6, 7).…”

Section: Introductionmentioning

confidence: 99%

Heart failure and central sleep apnea in the era of implantable recorders

Cabac-Pogorevici

Revenco

2021

Anatolian J Cardiol

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Sleep-disordered breathing (SDB) is a complex syndrome with a high prevalence and a significant impact on the general well-being of the overall population. Heart failure (HF) is a major health issue with an increasing incidence, a high rate of hospitalizations, and high mortality in developing countries. Focusing on early recognition and management of HF comorbidities may have an important role in reducing the economic burden and public health impact of HF. The close interconnection between HF, heart rhythm disturbances, and sleep apnea is supported by the mutual risk factors such as age, smoking, obesity, and male sex. Central sleep apnea (CSA) may be considered a marker of advanced HF, often being associated with elevated pulmonary capillary wedge pressure, brain natriuretic peptide (BNP), and noradrenaline levels and with low left ventricular ejection fraction. In the same way, there is an important correlation between CSA and different types of arrhythmias. The large intraindividual rhythm variability reported in patients with SDB who underwent continuous monitoring by implantable loop recorder (ILR) demonstrated the incapacity of 24-hour and 48-hour Holter monitoring to accurately determine the incidence of cardiac arrhythmias. In patients with HF and CSA, the extended cardiac monitoring by ILR becomes compulsory because in-time interventions could be life saving, but with the absolute lack of solid evidence in this field, there is an acute need for extensive randomized trials to further highlight the potential beneficial effect of ILR monitoring in patients with CSA and HF.

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Obstructive Sleep Apnoea Syndrome: Continuous Positive Airway Pressure Therapy for Prevention of Cardiovascular Risk

Cited by 12 publications

References 63 publications

Cardiovascular manifestations in obstructive sleep apnea: current evidence and potential mechanisms

Cardiovascular manifestations in obstructive sleep apnea: current evidence and potential mechanisms

Asian Pacific Society of Cardiology Consensus Statements on the Diagnosis and Management of Obstructive Sleep Apnoea in Patients with Cardiovascular Disease

Heart failure and central sleep apnea in the era of implantable recorders

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