Association and Risk Factors for Obstructive Sleep Apnea and Cardiovascular Diseases: A Systematic Review

Abstract

Obstructive sleep apnea (OSA) is a serious, potentially life-threatening condition. Epidemiologic studies show that sleep apnea increases cardiovascular diseases risk factors including hypertension, obesity, and diabetes mellitus. OSA is also responsible for serious illnesses such as congestive heart failure, stroke, arrhythmias, and bronchial asthma. The aim of this systematic review is to evaluate evidence for the association between OSA and cardiovascular disease morbidities and identify risk factors for the conditions. In a review of 34 studies conducted in 28 countries with a sample of 37,599 people, several comorbidities were identified in patients with severe OSA—these were: heart disease, stroke, kidney disease, asthma, COPD, acute heart failure, chronic heart failure, hyperlipidemia, thyroid disease, cerebral infarct or embolism, myocardial infarction, and psychological comorbidities including stress and depression. Important risk factors contributing to OSA included: age > 35 years; BMI ≥ 25 kg/m2; alcoholism; higher Epworth sleepiness scale (ESS); mean apnea duration; oxygen desaturation index (ODI); and nocturnal oxygen desaturation (NOD). Severe OSA (AHI ≥ 30) was significantly associated with excessive daytime sleepiness and oxygen desaturation index. The risk of OSA and associated disease morbidities can be reduced by controlling overweight/obesity, alcoholism, smoking, hypertension, diabetes mellitus, and hyperlipidemia.

CPAP Therapy on Depressive and Anxiety Symptoms in Patients with Moderate to Severe Obstructive Sleep Apnea Syndrome

“…Moreover, OSA and depression have common risk factors associated with cardiovascular disease and metabolic syndrome [ 6 , 10 ]. The frequency of comorbidities in our study was represented by essential hypertension (63%), ischemic heart disease (28%), and diabetes mellitus (22%), as this result supports the previous argument.…”

“…Studies showed that the prevalence of moderate-to-severe sleep-disorder breathing in adults is 23.4% in women and 49.7% in men [ 4 ]. OSA is an independent risk factor for cardiovascular diseases, essential hypertension [ 5 , 6 ], coronary artery disease, stroke, cerebrovascular disease [ 7 , 8 ], metabolic syndrome [ 9 ], and diabetes [ 10 ]. Sleep fragmentation, hypoxia, and persistent sleep loss lead to symptoms, such as depression since the frontal lobe centers responsible for emotions are sensitive to poor quality sleep [ 11 ].…”

Obstructive sleep apnea and right ventricular function: A meta‐analysis of speckle tracking echocardiographic studies

“…A large amount of evidence supports the view that OSA is associated with an increased risk of non‐fatal and fatal cardiovascular (CV) events as well as all‐cause mortality. 5 , 6 One of the mechanisms underlying the poor CV prognosis in patients with OSA is the development of structural and functional cardiac changes triggered by the hemodynamic, hormonal and inflammatory consequences of nocturnal arterial desaturation. 7 , 8 …”

Obstructive sleep apnoea syndrome and anatomical factors: possible correlations

“…Moreover, previous review evidenced that sleep disorders matter in terms of cardiometabolic health and contribute to metabolic syndrome 5 . The severity of OSA is direct correlated to the risk of several disease comorbidities, including hypertension, diabetes, obesity, heart disease, and poor mental health 6 .…”