Between 40% and 80% of individuals with cardiovascular diseases also present with obstructive sleep apnea (OSA), a disorder that is neither well-known nor widely treated, according to a scientific publication from the Journal of the American Heart Association on August 18, 2021.
Obstructive sleep apnea occurs when there is an obstruction in the upper airways, causing repeated episodes of interrupted breathing during sleep. Symptoms include snoring, respiratory pauses, fragmented sleep, and daytime drowsiness. Overall, approximately 34% of middle-aged men and 17% of middle-aged women meet the diagnostic criteria for OSA.
The main risk factors include obesity, a large neck circumference, craniofacial anomalies, smoking, family history and nighttime nasal congestion.
Scientific Publication from the American Heart Association on Sleep Apnea and Cardiovascular Diseases
A scientific publication provides a comprehensive overview and analysis of current research, guiding future clinical decisions.
Main Findings:
- Obstructive sleep apnea is characterized by repetitive episodes, either complete or partial, of upper airway obstruction, leading to intermittent hypoxia, autonomic activation, and sleep fragmentation.
- Approximately 34% of middle-aged men and 17% of middle-aged women meet the diagnostic criteria for this disorder.
- Sleep disorders are common yet often undetected in middle-aged and older adults. Prevalence varies by race/ethnicity, sex, and degree of obesity.
- OSA is present in 40% to 80% of patients with hypertension, heart failure, coronary artery disease, pulmonary hypertension, atrial fibrillation, and stroke.
- Despite this high prevalence is seen in patients with cardiovascular disease , and they are vulnerable to the effects of sleep apnea and adverse cardiovascular outcomes, sleep apnea is not usually diagnosed or treated in clinical cardiological practice.
- Evaluation for sleep apnea is recommended in patients with resistant or poorly controlled hypertension, pulmonary hypertension, or recurrent atrial fibrillation following cardioversion or ablation.
- For patients with heart failure in functional class II to IV according to the New York Heart Association, and with suspected respiratory disorders or excessive daytime drowsiness, a formal sleep evaluation is considered appropriate.
- In cases of suspected sleep apnea in patients with tachycardia-bradycardia syndrome, ventricular tachycardia, or a history of cardiopulmonary arrest, a comprehensive sleep evaluation is strongly advised.
- After a stroke,clinical judgment should guide screening and treatment decisions.
- Patients experiencing nocturnal angina, heart attacks, arrhythmias, or receiving shocks from implantable cardioverter-defibrillators are at increased risk of having sleep apnea as a comorbidity.
- All patients diagnosed with OSA should begin treatment, which may include lifestyle modifications and weight loss, depending on individual needs.
- Continuous positive airway pressure (CPAP) therapy should be offered to patients with severe OSA. For those with mild or moderate OSA, or in cases of CPAP intolerance, oral appliances may be considered.
- Follow-up sleep tests are essential to assess the effectiveness of treatment.
In this scenario, it is important for the cardiologist to include a sleep apnea evaluation in their consultations so that treatment can begin as soon as a diagnosis is made. This approach can help improve the patient’s sleep and overall quality of life, while also potentially reducing cardiovascular risk.
Biologix Solution for Diagnosing Obstructive Sleep Apnea
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