Sleep apnea: A new 'risk factor' for cardiovascular disease?

In this News Brief we have reviewed a few ideas related to the association between sleep-disordered breathing and sleep apnea with hypertension. Issues related to obesity with and without sleep apnea have been discussed. The general idea is that sleep apnea (perhaps hypoxia) can evoke long-lasting sympathetic activation and vasoconstriction. This in turn can lead to a cascade of events that contributes to defects in vasomotor regulation and the development of hypertension and perhaps other cardiovascular diseases. From a practical perspective individuals working in the rehabilitation of patients with risk factors for cardiovascular disease should ask simple questions about sleep quality and snoring and have a low index of suspicion that patients with hypertension, obesity, and other elements of the so-called metabolic syndrome might also have sleep apnea. From a basic science perspective sleep apnea also raises many questions about baroreflex and chemoreflex control of the circulation (and how they interact) that are common to exercise.