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 - Funding Information:
Dr Somers is supported by the National Institutes of Health (NIH) grants HL65176 and HL134885. Prof. Cowie has had research funding from and provided consultancy advice to ResMed. Dr Linz’s institution has received on his behalf lecture fees and/or consulting fees and/or research grants from Bayer, LivaNova, and Respicardia. Dr Redline has received grant funding from the NIH and Jazz Pharma; and has received consulting fees from Jazz Pharma, Eisai Inc, Respicardia Inc, and Apnimed Inc. Dr Somers has served as a consultant for Jazz Pharmaceuticals, Respicardia, Sleep Number, and Baker Tilly. Dr Simonds has received research funding from ResMed.
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. (C) 2021 Published by Elsevier on behalf of the American College of Cardiology Foundation.
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. (C) 2021 Published by Elsevier on behalf of the American College of Cardiology Foundation.
KW - cardiovascular disease
KW - diagnosis
KW - prognosis
KW - sleep apnea
KW - treatment
KW - POSITIVE AIRWAY PRESSURE
KW - CHEYNE-STOKES RESPIRATION
KW - ADAPTIVE SERVO-VENTILATION
KW - CORONARY-HEART-DISEASE
KW - ATRIAL-FIBRILLATION RECURRENCE
KW - ROSTRAL FLUID SHIFT
KW - BLOOD-PRESSURE
KW - RESISTANT HYPERTENSION
KW - RISK-FACTOR
KW - VENTRICULAR-ARRHYTHMIAS
U2 - 10.1016/j.jacc.2021.05.048
DO - 10.1016/j.jacc.2021.05.048
M3 - (Systematic) Review article
C2 - 34353537
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 -