TY - JOUR
T1 - Sleep Disordered Breathing and Cardiovascular Disease
T2 - JACC State-of-the-Art Review
AU - Cowie, Martin R.
AU - Linz, Dominik
AU - Redline, Susan
AU - Somers, Virend K.
AU - Simonds, Anita K.
N1 - Publisher Copyright:
© 2021
PY - 2021/8/10
Y1 - 2021/8/10
N2 - Sleep disordered breathing causes repetitive episodes of nocturnal hypoxemia, sympathetic nervous activation, and cortical arousal, often associated with excessive daytime sleepiness. Sleep disordered breathing is common in people with, or at risk of, cardiovascular (CV) disease including those who are obese or have hypertension, coronary disease, heart failure, or atrial fibrillation. Current therapy of obstructive sleep apnea includes weight loss (if obese), exercise, and positive airway pressure (PAP) therapy. This improves daytime sleepiness. Obstructive sleep apnea is associated with increased CV risk, but treatment with PAP in randomized trials has not been shown to improve CV outcome. Central sleep apnea (CSA) is not usually associated with daytime sleepiness in heart failure or atrial fibrillation and is a marker of increased CV risk, but PAP has been shown to be harmful in 1 randomized trial. The benefits of better phenotyping, targeting of higher-risk patients, and a more personalized approach to therapy are being explored in ongoing trials.
AB - Sleep disordered breathing causes repetitive episodes of nocturnal hypoxemia, sympathetic nervous activation, and cortical arousal, often associated with excessive daytime sleepiness. Sleep disordered breathing is common in people with, or at risk of, cardiovascular (CV) disease including those who are obese or have hypertension, coronary disease, heart failure, or atrial fibrillation. Current therapy of obstructive sleep apnea includes weight loss (if obese), exercise, and positive airway pressure (PAP) therapy. This improves daytime sleepiness. Obstructive sleep apnea is associated with increased CV risk, but treatment with PAP in randomized trials has not been shown to improve CV outcome. Central sleep apnea (CSA) is not usually associated with daytime sleepiness in heart failure or atrial fibrillation and is a marker of increased CV risk, but PAP has been shown to be harmful in 1 randomized trial. The benefits of better phenotyping, targeting of higher-risk patients, and a more personalized approach to therapy are being explored in ongoing trials.
KW - cardiovascular disease
KW - diagnosis
KW - prognosis
KW - sleep apnea
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=85111040396&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85111040396&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2021.05.048
DO - 10.1016/j.jacc.2021.05.048
M3 - Review article
C2 - 34353537
AN - SCOPUS:85111040396
SN - 0735-1097
VL - 78
SP - 608
EP - 624
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 6
ER -