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JACC Journals › JACC › Archives › Vol. 84 No. 13
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Interactions of Obstructive Sleep Apnea With the Pathophysiology of Cardiovascular Disease, Part 1: JACC State-of-the-Art ReviewGET ACCESS

JACC State-of-the-Art Review

JACC. 2024 Sep, 84 (13) 1208–1223
Topic(s):
JACC State-of-the-Art Review: Treatment of OSA and its Impact on Cardiovascular Disease, Part 2: JACC State-of-the-Art Review
Sections

Abstract

The American Heart Association considers sleep health an essential component of cardiovascular health, and sleep is generally a time of cardiovascular quiescence, such that any deviation from normal sleep may be associated with adverse cardiovascular consequences. Many studies have shown that both impaired quantity and quality of sleep, particularly with obstructive sleep apnea (OSA) and comorbid sleep disorders, are associated with incident cardiometabolic consequences. OSA is associated with repetitive episodes of altered blood gases, arousals, large negative swings in intrathoracic pressures, and increased sympathetic activity. Recent studies show that OSA is also associated with altered gut microbiota, which could contribute to increased risk of cardiovascular disease. OSA has been associated with hypertension, atrial fibrillation, heart failure, coronary artery disease, stroke, and excess cardiovascular mortality. Association of OSA with chronic obstructive lung disease (overlap syndrome) and morbid obesity (obesity hypoventilation syndrome) increases the odds of mortality.

Highlights

•

OSA is associated with increased cardiovascular risk, amplified by OHS and overlap syndromes.

•

The presentation and cardiovascular implications of OSA differ between men and women.

•

Potential mechanism linking sleep apnea to incident CVD may involve alterations in the gut microbiome.

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