Sleep Disorders and Cardio-Renal Disease: Implications for Minority Populations

Abstract

Obesity is a major public health problem that is reaching pandemic proportion. Currently two thirds of the American population is either overweight or obese and worldwide, 39% of the population is overweight and 13% are considered obese [1,2]. This rapid rise in obesity is associated with increased in diabetes mellitus type 2 (DM2), hypertension (HTN), chronic kidney disease (CKD) and cardiovascular diseases (CVD), the major killer of adults in the USA. Parallel to this epidemic is the rapid rise of sleep disorders such as Obstructive Sleep Apnea (OSA). These disorders lead to increased morbidity and mortality and generally go undiagnosed and undertreated, particularly among minority groups. Accumulating evidence indicates common pathophysiologic background underlying all of these related disorders. Among these include: increased inflammation, increased oxidative stress, endothelial dysfunction, dyslipidemia and hypercoagulability. We discuss the rising epidemic of sleep disorders and its interrelationship with DM2, HTN, CVD and renal disease highlighting the racial disparity in diagnosis and treatment of these disorders that disproportionately affects minority populations. We also discuss the various treatment modalities and the cutting edge developments in this field.

The effect of obstructive sleep apnea syndrome on serum S100B and NSE levels: a systematic review and meta-analysis of observational studies

“…OSAS can be related to cardiovascular and metabolic disorders, high blood pressure, diabetes, obesity, coronary artery illness [23,24], stroke, and heart failure [25,26]. OSAS can also cause cellular injury in the central nervous system (CNS) [27].…”

Sleep disturbances: one of the culprits of obesity-related cardiovascular risk?

“…The prevalence of OSA, estimated as Apnea Hypopnea Index / Respiratory Disturbance Index (AHI/ RDI) greater than 5, varies between 9% and 38% (men 13-33%, women 6-19%) in the adult population [9]. SD is a common finding in obesity; in fact it has been reported that almost 70% of patients with OSA are obese and most of them develop obesity-related cardiovascular risk factors [10][11][12].…”

Obesity, Cardiovascular Disease and Sleep Disorders: Insights into the Rising Epidemic

“…Not only is obesity one of the main causes of OSA, affecting 70% of the patients with OSA, it also shares some of the underlying pathophysiologic mechanisms with obesity-related diseases, such as DM2, HTN and CVD [3,4]. Furthermore, OSA increases risk of end-organ damage in critically ill patients.…”