Obstructive Sleep Apnea and Cardiovascular Disease

2021 ◽  
Author(s):  
Joseph A. Diamond ◽  
Haisam Ismail
Keyword(s):  
Cardiovascular Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep

Randomized clinical trials of cardiovascular disease in obstructive sleep apnea: understanding and overcoming bias

SLEEP ◽  
2021 ◽  
Vol 44 (4) ◽  
Author(s):  
R Doug McEvoy ◽  
Manuel Sánchez-de-la-Torre ◽  
Yüksel Peker ◽  
Craig S Anderson ◽  
Susan Redline ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Clinical Trials ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Randomized Clinical Trials ◽  
Obstructive Sleep

Cardiovascular outcomes of CPAP therapy in obstructive sleep apnea syndrome

2007 ◽  
Vol 293 (4) ◽  
pp. R1666-R1670 ◽  
Author(s):  
Walter T. McNicholas
Keyword(s):  
Cardiovascular Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Cpap Therapy ◽  
Obstructive Sleep ◽  
Cardiovascular Morbidity And Mortality ◽  
Apnea Syndrome ◽  
The Impact

Considerable evidence is now available of an independent association between obstructive sleep apnea syndrome (OSAS) and cardiovascular disease. The association is particularly strong for systemic arterial hypertension, but there is growing evidence of an association with ischemic heart disease and stroke. The mechanisms underlying cardiovascular disease in patients with OSAS are still poorly understood. However, the pathogenesis is likely to be a multifactorial process involving a diverse range of mechanisms, including sympathetic overactivity, selective activation of inflammatory molecular pathways, endothelial dysfunction, abnormal coagulation, and metabolic dysregulation, the latter particularly involving insulin resistance and disordered lipid metabolism. Therapy with continuous positive airway pressure (CPAP) has been associated with significant benefits to cardiovascular morbidity and mortality, both in short-term studies addressing specific aspects of morbidity, such as hypertension, and more recently in long-term studies that have evaluated major outcomes of cardiovascular morbidity and mortality. However, there is a clear need for further studies evaluating the impact of CPAP therapy on cardiovascular outcomes. Furthermore, studies on the impact of CPAP therapy have provided useful information concerning the role of basic cell and molecular mechanisms in the pathophysiology of OSAS.

scholarly journals CPAP treatment, glycemia and diabetes risk in obstructive sleep apnea and comorbid cardiovascular disease

2020 ◽  
Author(s):  
Kelly A. Loffler ◽  
Emma Heeley ◽  
Ruth Freed ◽  
Rosie Meng ◽  
Lia R. Bittencourt ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Glycemic Control ◽  
Usual Care ◽  
Serum Glucose ◽  
Cpap Therapy ◽  
Cpap Treatment ◽  
Obstructive Sleep

Objective: Despite evidence of a relationship between obstructive sleep apnea (OSA), metabolic dysregulation and diabetes mellitus (DM), it is uncertain whether OSA treatment can improve metabolic parameters. We sought to determine effects of long-term continuous positive airway pressure (CPAP) treatment on glycemic control and DM risk in patients with cardiovascular disease (CVD) and OSA. <strong>Research Design and Methods: </strong>Blood, medical history, and personal data were collected in a <strong>substudy of 888 participants in the </strong>Sleep Apnea Cardiovascular Endpoints (SAVE) trial in which patients with OSA and stable CVD were r<strong>andomized</strong> to receive CPAP plus Usual Care, or Usual Care alone. Serum glucose and glycated hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) were measured at baseline, and six months, two- and four years, and incident diabetes diagnoses recorded. Results: Median follow-up was 4.3 years. In those with pre-existing DM (n=274), there was no significant difference between CPAP and Usual Care groups in serum glucose, HbA<sub>1c</sub> or anti-diabetic medications during follow-up. There were also no significant between-group differences in participants with pre-diabetes (n=452), nor in new diagnoses of DM. Interaction testing suggested that women with diabetes did poorly in the Usual Care group while their counterparts on CPAP therapy remained stable. <strong>Conclusions</strong><b>:</b> Among patients with established CVD and OSA, we found no evidence that CPAP therapy over several years affected glycemic control in those with diabetes or pre-diabetes, or DM risk over standard of care treatment. The potential differential effect according to sex deserves further investigation.

scholarly journals Apnea Monitor based on Bluetooth with Android Interface

2020 ◽  
Vol 1 (2) ◽  
pp. 50-56
Author(s):  
I Dewa Made Wirayuda ◽  
I Dewa Gede Hari Wisana ◽  
Priyambada Cahya Nugraha
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sudden Death ◽  
Respiration Rate ◽  
Average Error ◽  
Obstructive Sleep ◽  
Testing And Measurement ◽  
Mit App Inventor

Apnea monitor is a device that is used to give a warning if there is stop breathing. Stop breathing while sleeping is one form of obstructive sleep apnea. This cessation of breath cannot be underestimated, this is related to the main risk factors for health implications and increased cardiovascular disease and sudden death. The purpose of this study is to design an apnea monitor with the Android interface. This device allows the users to get how many times sleep apnea happens while sleeping and got data to analysis before continuing with a more expensive and advanced sleep test. This device used a flex sensor to detect the respiration rate, the sensor placed on the abdomen or belly so it can measure expand and deflate while breathing. The microcontroller uses an Arduino chip called AT-Mega328. Bluetooth HC-05 used to send respiration data to Android, MIT app inventor used for the android programmer, and on the android, there are plotting of respiration value and when the device detected apnea so the android also gives a warning to the user. Based on the results of testing and measurement then compare with another device, the results of the average% error were 3.61%. This apnea monitor design is portable but there are needs some improvement by using another sensor for detected respiration and using a module other than Bluetooth.

scholarly journals Prevalence of Undiagnosed Obstructive Sleep Apnea Among Patients Hospitalized for Cardiovascular Disease and Associated In-Hospital Outcomes: A Scoping Review

2020 ◽  
Vol 9 (4) ◽  
pp. 989
Author(s):  
Colin Suen ◽  
Jean Wong ◽  
Clodagh M. Ryan ◽  
Samuel Goh ◽  
Tiffany Got ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Scoping Review ◽  
Left Ventricular ◽  
Cardiac Biomarkers ◽  
Left Ventricular Ejection ◽  
Hospital Outcomes ◽  
Ventricular Ejection Fraction ◽  
Obstructive Sleep

Background: Obstructive sleep apnea (OSA) is associated with long-term cardiovascular morbidity and is highly prevalent in patients with cardiovascular disease (CVD). The objectives of this scoping review were to determine the prevalence of OSA inpatients hospitalized for CVD and to map the range of in-hospital outcomes associated with OSA. Methods: We searched MEDLINE(R), Embase, and Cochrane Databases for articles published from 1946–2018. We included studies involving non-surgical adults with OSA or at high risk of OSA who were hospitalized for CVD. The outcomes were considered as in-hospital if they were collected from admission up to 30 days post-discharge from hospital. Results: After the screening of 4642 articles, 26 studies were included for qualitative synthesis. Eligible studies included patients presenting with acute coronary syndromes (n = 19), congestive heart failure (n = 6), or any cardiovascular disease (n = 1). The pooled prevalence of OSA in cardiac inpatients was 48% (95% CI: 42–53). The in-hospital outcomes reported were mortality (n = 4), length of stay (n = 8), left ventricular ejection fraction (n = 8), peak troponin (n = 7), peak B-type natriuretic peptide (n = 4), and composite cardiovascular complications (n = 2). Conclusions: OSA is highly prevalent in the cardiac inpatient population. The outcomes reported included mortality, cardiac function, cardiac biomarkers, and resource utilization. There are significant knowledge gaps regarding the effect of treatment and OSA severity on these outcomes. The findings from this review serve to inform further areas of research on the management of OSA among patients with CVD.

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