Sleep Apnea and Cardiovascular Morbidity—a Perspective

Abstract

In this paper, we analyzed the principal mechanisms linking OSA and cardiovascular diseases, the magnitude of this association, and the effect of treatment on cardiovascular risk reduction. Furthermore, we focused on big data and genomic approaches that may expand the innovative horizon aimed at personalized treatment of OSA. Patients with obstructive sleep apnea (OSA) are more prone to suffer from cardiovascular diseases and their complications. Arousal from sleep, changes in intrathoracic pressures, and intermittent episodes of hypoxemia and re-oxygenation trigger intermediate mechanisms that are responsible for the cardiovascular consequences of OSA. The impact of OSA on cardiovascular health, such as the effect of continuous positive airway pressure (CPAP) treatment on cardiovascular risk, may vary among different patient profiles. In spite of increasing interest towards personalized therapy for OSA, observational studies and randomized clinical trials have failed to conclusively determine which OSA phenotypes may benefit most from treatment, particularly in terms of reducing cardiovascular risk.