Obstructive sleep apnea and sudden death

Obstructive sleep apnea (OSA) is a highly prevalent condition that is associated with a broad range of cardiovascular disease conditions. The pathophysiological events during apneas in patients with OSA cause acute and often profound autonomic, cardiac, and vascular changes during sleep, and may also result in daytime abnormalities of neural circulatory control and cardiovascular structure and function. These changes may contribute to sudden death during sleep and may increase the risk of sudden death during the day. We will review the epidemiology of OSA, the physiology of normal sleep, the distinctive pathophysiology of sleep in patients with OSA, the mechanisms by which OSA may increase the risk of sudden death, and available population data that support such a relationship.