Cardiovascular morbidity in obstructive sleep apnea

The repetitive respiratory events that characterize obstructive sleep apnea (OSA) are each followed by abrupt increases in heart rate and in pulmonary and systemic artery pressure and by sudden decreases in right and left ventricular stroke volume. The changes in systemic pressure may be profound, w...

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Bibliographic Details
Published in:Progress in cardiovascular diseases 1999-04, Vol.41 (5), p.367-376
Main Authors: Weiss, J.Woodrow, Launois, Sandrine H, Anand, Amit, Garpestad, Erik
Format: Article
Language:English
Subjects:
Acute Disease
Biological and medical sciences
Blood Pressure
Cardiovascular Diseases - etiology
Cardiovascular Diseases - physiopathology
Chronic Disease
Heart Rate
Hemodynamics
Humans
Medical sciences
Pneumology
Respiratory system : syndromes and miscellaneous diseases
Sleep Apnea Syndromes - complications
Sleep Apnea Syndromes - physiopathology
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Summary:The repetitive respiratory events that characterize obstructive sleep apnea (OSA) are each followed by abrupt increases in heart rate and in pulmonary and systemic artery pressure and by sudden decreases in right and left ventricular stroke volume. The changes in systemic pressure may be profound, with patients who are normotensive while awake having systolic pressures approaching 300 mm Hg after apnea termination. Because of these dramatic hemodynamic oscillations during sleep, many clinicians and investigators have postulated a connection between sleep-disordered breathing and cardiovascular morbidity and even mortality. This review critically examines the evidence for such a causal relationship. We begin, however, by reviewing the normal hemodynamic changes that occur during sleep. We then describe the acute hemodynamic events associated with OSA. Finally, we summarize the evidence for and against a causal connection between sleep apnea and cardiovascular morbidity. Copyright © 1999 by W.B. Saunders Company Progress in Cardiovascular Diseases, Vol. 41, No. 5 (March/April), 1999: pp 367-376
ISSN:0033-0620
1532-8643
DOI:10.1053/pcad.1999.0410367