Sleep apnoea and the heart
Open Access
- 30 August 2013
- journal article
- review article
- Published by European Respiratory Society (ERS) in European Respiratory Review
- Vol. 22 (129), 333-352
- https://doi.org/10.1183/09059180.00004513
Abstract
Sleep apnoea is associated with significant daytime functioning impairment and marked cardiovascular morbidities, leading to a significant increase in mortality. Sympathetic activation, oxidative stress and systemic inflammation have been shown to be the main intermediary mechanisms associated with sleep apnoea and intermittent hypoxia. There are now convincing data regarding the association between hypertension, arrhythmias, coronary heart disease, heart failure, increased cardiovascular mortality and sleep apnoea. This has been evidenced in sleep apnoea patients and is supported by experimental data obtained in intermittent hypoxia. Whether treating sleep apnoea enables chronic cardiovascular consequences to be reversed is not fully established as regard coronary heart disease, arrhythmias and heart failure. In this late condition, complex bidirectional relationships occur, with obstructive sleep apnoea being a risk factor for heart failure whilst central sleep apnoea mainly appears as a consequence of heart failure. It remains to be established in adequately designed studies, i.e. large randomised controlled trials, whether treating sleep apnoea can improve heart failure morbidity and mortality.Keywords
This publication has 98 references indexed in Scilit:
- Rationale and design of the SERVE‐HF study: treatment of sleep‐disordered breathing with predominant central sleep apnoea with adaptive servo‐ventilation in patients with chronic heart failureEuropean Journal of Heart Failure, 2013
- Relationship between atrial conduction delay and obstructive sleep apneaHeart and Vessels, 2012
- Relation of the Severity of Obstructive Sleep Apnea in Response to Anti-Arrhythmic Drugs in Patients With Atrial Fibrillation or Atrial FlutterThe American Journal of Cardiology, 2012
- Impact of repeated daily exposure to intermittent hypoxia and mild sustained hypercapnia on apnea severityJournal of Applied Physiology, 2012
- Transvenous phrenic nerve stimulation for the treatment of central sleep apnoea in heart failureEuropean Heart Journal, 2011
- Effect of intermittent hypoxia on atherosclerosis in apolipoprotein E-deficient miceAtherosclerosis, 2009
- Triggering of Nocturnal Arrhythmias by Sleep-Disordered Breathing EventsJournal of the American College of Cardiology, 2009
- ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM)European Heart Journal, 2008
- Effect of CPAP on insulin resistance and HbA1c in men with obstructive sleep apnoea and type 2 diabetesThorax, 2007
- Inflammation in atherosclerosisNature, 2002