Sleep Apnea: Types, Mechanisms, and Clinical Cardiovascular Consequences

Shahrokh Javaheri, Ferran Barbe, Francisco Campos-Rodriguez, Jerome A. Dempsey, Rami Khayat, Sogol Javaheri, Atul Malhotra, Miguel A. Martinez-Garcia, Reena Mehra, Allan I. Pack, Vsevolod Y. Polotsky, Susan Redline, Virend K. Somers

Research output: Contribution to journalReview articlepeer-review

362 Scopus citations

Abstract

Sleep apnea is highly prevalent in patients with cardiovascular disease. These disordered breathing events are associated with a profile of perturbations that include intermittent hypoxia, oxidative stress, sympathetic activation, and endothelial dysfunction, all of which are critical mediators of cardiovascular disease. Evidence supports a causal association of sleep apnea with the incidence and morbidity of hypertension, coronary heart disease, arrhythmia, heart failure, and stroke. Several discoveries in the pathogenesis, along with developments in the treatment of sleep apnea, have accumulated in recent years. In this review, we discuss the mechanisms of sleep apnea, the evidence that addresses the links between sleep apnea and cardiovascular disease, and research that has addressed the effect of sleep apnea treatment on cardiovascular disease and clinical endpoints. Finally, we review the recent development in sleep apnea treatment options, with special consideration of treating patients with heart disease. Future directions for selective areas are suggested.

Original languageEnglish (US)
Pages (from-to)841-858
Number of pages18
JournalJournal of the American College of Cardiology
Volume69
Issue number7
DOIs
StatePublished - Feb 21 2017

Keywords

  • central sleep apnea
  • hypertension
  • obstructive sleep apnea

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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