The Burden of Comorbidities in Obstructive Sleep Apnea and the Pathophysiologic Mechanisms and Effects of CPAP

Abstract

Micro-arousals and the repeated desaturation of oxyhemoglobin, which are typical in obstructive sleep apnea syndrome (OSAS), have adverse effects on the health of patients, leading to a wide range of complications such as cardiovascular (arterial hypertension, pulmonary hypertension, chronic heart failure, arrhythmias, myocardial infarction), cerebrovascular (strokes), metabolic (insulin resistance, obesity, diabetes mellitus, metabolic syndrome), gastrointestinal (non-alcoholic liver disease), urinary (chronic renal failure), and neuropsychiatric complications as well as a wide range of malignancies. These, in turn, have multilateral effects on familial, occupational, and social life, as well as increasing the risks of road traffic accidents and accidents at the workplace. Awareness, timely screening, and the prevention of complications play important roles in diagnosing and treating comorbid conditions. This review focuses on comorbidities in OSAS and the effect of Continuous Positive Airway Pressure (CPAP) therapy on their prognoses.

The Present and Future of the Clinical Use of Physiological Traits for the Treatment of Patients with OSA: A Narrative Review

“…Untreated OSA is associated with major causes of morbidity and mortality, including hypertension, strokes, coronary artery disease, metabolic syndrome, cognitive impairment, and mood disorders [ 4 , 5 , 6 ]. The timely diagnosis and treatment of OSA may have a role in mitigating the development or progression of these comorbid conditions [ 7 ]. Positive airway pressure (PAP) therapy is the gold standard and most efficacious therapy for OSA [ 8 ], and is prescribed to 80% of those diagnosed with OSA [ 9 ].…”

Symptom and comorbidity burden in hypertensive patients with obstructive sleep apnea

“…Patients with OSA may present with a variety of symptoms, including habitual snoring, fatigue, poor sleep quality, excessive daytime sleepiness (EDS), memory loss, headaches, and psychological disturbances ( 3 ). Many studies have confirmed that untreated OSA can damage multiple systems and organs and cause a variety of complications, including cardiovascular diseases, ischemic stroke, metabolic-related diseases, and neuropsychiatric complications ( 4 – 7 ).…”

A Systematic Review and Meta-Analysis of Mean Platelet Volume and Platelet Distribution Width in Patients with Obstructive Sleep Apnoea Syndrome

“…Partial or complete obstruction of the upper airways during sleep, leading to episodes of apnoea or hypopnea, is the hallmark of the disease [5][6][7]. These events may result in metabolic changes, endothelial dysfunction, proinflammatory factor activation, and systemic oxidative stress, all of which raise the risk of cardiovascular disease [8][9][10][11][12]. In light of this, treatment is based on restoring physiological oxygen intake through continuous positive airway pressure (CPAP) therapy or surgical Biomedicines 2024, 12, 270 2 of 16 therapies addressing specific causative factors (i.e., maxillary expansion, maxillomandibular or jaw advancement surgery) [10,11].…”

“…These events may result in metabolic changes, endothelial dysfunction, proinflammatory factor activation, and systemic oxidative stress, all of which raise the risk of cardiovascular disease [8][9][10][11][12]. In light of this, treatment is based on restoring physiological oxygen intake through continuous positive airway pressure (CPAP) therapy or surgical Biomedicines 2024, 12, 270 2 of 16 therapies addressing specific causative factors (i.e., maxillary expansion, maxillomandibular or jaw advancement surgery) [10,11]. The number of apnoeic or hypopneic occurrences per hour of sleep (apnoea-hypopnea index-AHI), is used to stratify the severity of OSAS into three categories-mild (5 ≤ AHI < 15), moderate (15 ≤ AHI < 30), and severe (AHI ≥ 30)-as determined in a polysomnography (PSG) sleep study [13], the standard diagnostic tool for OSAS.…”