International Journal of Cardiology
Volume 139, Issue 1 , Pages 7-16 , 18 February 2010

Obstructive sleep apnea and cardiovascular disease

  • Mehmood Butt

      Affiliations

    • University Department of Medicine, City Hospital, Birmingham B18 7QH, UK
    • ,
  • Girish Dwivedi

      Affiliations

    • University Department of Medicine, City Hospital, Birmingham B18 7QH, UK
    • ,
  • Omer Khair

      Affiliations

    • Department of Respiratory Medicine, City Hospital Birmingham B18 7QH, UK
    • ,
  • Gregory Y.H. Lip

      Affiliations

    • University Department of Medicine, City Hospital, Birmingham B18 7QH, UK
    • Corresponding Author InformationCorresponding author. Tel.: +44 121 507 5080; fax: +44 121 507 5907.

Received 14 March 2009 ,Revised 7 May 2009 ,Accepted 11 May 2009.

References 

  1. Phillipson EA. Sleep apnea—a major public health problem. N Engl J Med. 1993;328:1271–1273
  2. Shamsuzzaman ASM, Gersh BJ, Somers VK. Obstructive sleep apnea implications for cardiac and vascular disease. JAMA. 2003;290:1906–1914
  3. Chobanian AV, Bakris GL, Black HR, et al. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–1252
  4. Ferini-strambi L, fantini ML, Castronovo C. Epidemiology of sleep apnea syndrome. Minerva Med. 2004;95:187–202
  5. Redline S, Kump K, Tishler PV, Browner I, Ferrette V. Gender differences in sleep disordered breathing in a community-based sample. Am J Respir Crit Care Med. 1994;149:722–726
  6. Nieto FJ, Young TB, Lind BK, et al. Association of sleep-disordered breathing, sleep apnea and hypertension in a large community-based study. JAMA. 2000;283:1829–1836
  7. Durán CJ. Prevalence of obstructive sleep apnea–hypopnea and related clinical features in the elderly: a population based study in the general population aged 71–100. In: World Conference 2001 Sleep Odyssey. Uruguay: Montevideo; October 21–26 2001;
  8. Durán J, Esnaola S, Rubio R, Iztueta A. Obstructive sleep apnea–hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am J Respir Crit Care Med. 2001;163:685–689
  9. Young T, Shahar E, Nieto FJ, et al. Sleep Heart Health Study Research Group. Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Arch Intern Med. 2002;162:893–900
  10. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–1235
  11. Bixler EO, Vgontzas AN, Ten Have T, Tyson K, Kales A. Effects of age on sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med. 1998;157:144–148
  12. Peppard PE, Young T, Palta M, Dempsey J, Skatrud J. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA. 2000;284:3015–3021
  13. Sin DD, Fitzgerald F, Parker JD, Newton G, Floras JS, Bradley TD. Risk factors for central and obstructive sleep apnea in 450 men and women with congestive cardiac failure. Am J respire Crit care med. 1999;160:1101–1106
  14. Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med. 2005;353:2034–2041
  15. Hanly PJ, Pierratos A. Improvement of sleep apnea in patients with chronic renal failure who undergo nocturnal hemodialysis. N Engl J Med. 2001;344:102–107
  16. Shahar E, Whitney CW, Redline ET, Lee S, et al. Sleep disordered breathing and cardiovascular disease: cross sectional results of sleep heart health study. Am J respire Crit care med. 2001;163:19–25
  17. Worsnop CT, Naughton MT, Barter CE, Morgan TO, Anderson AI, Pierce RJ. The prevalence of obstructive sleep apnea in hypertensives. Am J Respir Crit Care Med. 1998;157:111–115
  18. Sanner BM, Doberauer C, Konermann M Sturm A, Zidek W. Pulmonary hypertension in patients with obstructive sleep apnea syndrome. Arch Intern Med. 1997;157:2483–2487
  19. Hoffstein V, Mateika S. Cardiac arrhythmias, snoring, and sleep apnea. Chest. 1994;106:466–471
  20. Dyken ME, Somers VK, Yamada T, Ren ZY, Zimmerman MB. Investigating the relationship between stroke and obstructive sleep apnea. Stroke. 1996;27:401–407
  21. Grebe M, Eisele HJ, Weissmann N, et al. Antioxidant vitamin C improves endothelial function in obstructive sleep apnea. Am J Respir Crit Care Med. 2006;173:897–901
  22. Kato M, Roberts-Thomson P, Phillips BG, et al. Impairment of endothelium-dependent vasodilation of resistance vessels in patients with obstructive sleep apnea. Circulation. 2000;102:2607–2610
  23. Budhiraja R, Parthasarathy S, Quan SF. Endothelial dysfunction in obstructive sleep apnea. J Clin Sleep Med. 2007;3:409–415
  24. Napoli C, Ignarro LJ. Nitric oxide and atherosclerosis. Nitric Oxide. 2001;5:88–97
  25. Harrison DG, Cai H. Endothelial control of vasomotion and nitric oxide production. Cardiol Clin. 2003;21:289–302
  26. Budhiraja R, Tuder RM, Hassoun PM. Endothelial dysfunction in pulmonary hypertension. Circulation. 2004;109:159–165
  27. Chin K, Kita H, Noguchi T, et al. Improvement of factor VII clotting activity following long-term NCPAP treatment in obstructive sleep apnea syndrome. Q J Med. 1998;91:627–633
  28. Sanner BM, Konermann M, Tepel M, Groetz J, Mummenhoff C, Zidek W. Platelet function in patients with obstructive sleep apnoea syndrome. Eur Respir J. 2000;16:648–652
  29. El-Solh AA, Mador MJ, Sikka P, Dhillon RS, Amsterdam D, Grant BJB. Adhesion molecules in patients with coronary artery disease and moderate to severe obstructive sleep apnea. Chest. 2002;121:1541–1547
  30. Venugopal SK, Devaraj S, Yuhanna I, Shaul P, Jialal I. Demonstration that C-reactive protein decreases eNOS expression and bioactivity in human aortic endothelial cells. Circulation. 2002;106:1439–1441
  31. Valgimigli M, Merli E, Malagutti P, et al. Endothelial dysfunction in acute and chronic coronary syndromes: evidence for a pathogenetic role of oxidative stress. Arch Biochem Biophys. 2003;420:255–261
  32. Celermajer DS, Adams MR, Clarkson P, Robinson J, McCredie R, Donald A. Passive smoking and impaired endothelium dependent arterial dilatation in healthy young adults. New Eng J Med. 1996;334:150–154
  33. Panza JA, Quyyumi AA, Brush JE, Epstein SE. Abnormal endothelium-dependent vascular relaxation in patients with essential hypertension. New Eng J Med. 1990;323:22–27
  34. Linder L, Kiowski W, Buhler FR, Luscher TF. Indirect evidence for release of endothelium-derived relaxing factor in human forearm circulation in vivo. Blunted response in essential hypertension. Circulation. 1990;81:1762–1767
  35. Ohike Y, Kozaki K, Iijima K, Eto M, Kojima T, Ohga E. Amelioration of vascular endothelial dysfunction in obstructive sleep apnea syndrome by nasal continuous positive airway pressure. Possible involvement of nitric oxide and asymmetric NG, NG Dimethylarginine. Circ J. 2005;69:221–226
  36. Shamsuzzaman ASM, Winnicki M, Lanfranchi P, et al. Elevated C-reactive protein in patients with obstructive sleep apnea. Circulation. 2002;105:2462–2464
  37. Ip MSM, Tse HF, Lam B, Tsang KWT, Lam WK. Endothelial function in obstructive sleep apnea and response to treatment. Am J Respir Crit Care Med. 2004;169:348–353
  38. Lattimore JL, Wilcox I, Skilton M, Langenfeld M, Celermajer DS. Treatment of obstructive sleep apnoea leads to improved microvascular endothelial function in the systemic circulation. Thorax. 2006;61:491–495
  39. Solin P, Kaye DM, Little PJ, Bergin P, Richardson M, Naughton MT. Impact of sleep apnea on sympathetic nervous system activity in heart failure. Chest. 2003;123:1119–1126
  40. Narkiewicz K, Van de Borne PJH, Cooley RL, Dyken ME, Somers VK. Sympathetic activity in obese subjects with and without obstructive sleep apnea. Circulation. 1998;98:772–776
  41. Somers VK, Dyken ME, Clary MP, Abboud FM. Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest. 1995;96:1897–1904
  42. Duffin J. The chemoreflex control of breathing and its measurement. Can J Anaesth. 1990;37:933–942
  43. Narkiewicz K, Van de Borne PJH, Montano N, Dyken ME, Phillips BG, Somers VK. Contribution of tonic chemoreflex activation to sympathetic activity and blood pressure in patients with obstructive sleep apnea. Circulation. 1998;97:943–945
  44. Tilkian AG, Guilleminault C, Schroeder JS, Lehrman KL, Simmons FB, Dement EC. Hemodynamics in sleep-induced apnea: studies during wakefulness and sleep. Ann Intern Med. 1976;85:714–719
  45. Kataoka M, Ito C, Sasaki H, Yamane K, Kohno N. Low heart rate variability is a risk factor for sudden cardiac death in type 2 diabetes. Diabetes Res Clin Pract. 2004;64:51–58
  46. Hadase M, Azuma A, Zen K, et al. Very low frequency power of heart rate variability is a powerful predictor of clinical prognosis in patients with congestive heart failure. Circ J. 2004;68:343–347
  47. Kleiger RE, Miller JP, Bigger JT, Moss AJ. Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol. 1987;59:256–262
  48. Singh JP, Larson MG, Tsuji H, Evans JC, O’Donnell CJ, Levy D. Reduced heart rate variability and new-onset hypertension; insights into pathogenesis of hypertension: the Framingham Heart Study. Hypertension. 1998;32:293–297
  49. Narkiewicz K, Montano N, Cogliati C, Van de Borne PJH, Dyken ME, Somers VK. Altered cardiovascular variability in obstructive sleep apnea. Circulation. 1998;98:1071–1077
  50. Palatini P, Penzo M, Racioppa A, et al. Clinical relevance of nighttime blood pressure and of daytime blood pressure variability. Arch Intern Med. 1992;152:1855–1860
  51. Frattola A, Parati G, Cuspidi C, Albini F, Mancia G. Prognostic value of 24-hour blood pressure variability. J Hypertens. 1993;11:1133–1137
  52. Kannel WB, Wolf PA, Castelli WP, D'Agostino RB. Fibrinogen and risk of cardiovascular disease: the Framingham Study. JAMA. 1987;258:1183–1186
  53. Pearson JD. Vessel wall interactions regulating thrombosis. Br Med Bull. 1994;50:776–788
  54. Eisensehr I, Ehrenberg BL, Noachtar S, et al. Platelet activation, epinephrine, and blood pressure in obstructive sleep apnea syndrome. Neurology. 1998;51:188–195
  55. Bokinsky G, Miller M, Ault K, Husband P, Mitchell J. Spontaneous platelet activation and aggregation during obstructive sleep apnea and its response to therapy with nasal continuous positive airway pressure. Chest. 1995;108:625–630
  56. Hoffstein V, Herridge M, Mateika S, Redline S, Strohl KP. Hematocrit levels in sleep apnea. Chest. 1994;106:787–791
  57. Wessendorf TE, Thilmann AF, Wang YM, Schreiber A, Konietzko N, Teschler H. Fibrinogen levels and obstructive sleep apnea in ischemic stroke. Am J Respir Crit Care Med. 2000;162:2039–2042
  58. Robinson GV, Pepperell JCT, Segal HC, Davies RJO, Stradling JR. Circulating cardiovascular risk factors in obstructive sleep apnoea: data from randomised controlled trials. Thorax. 2004;59:777–782
  59. Lavie L. Obstructive sleep apnoea syndrome—an oxidative stress disorder. Sleep Med Rev. 2003;7:35–51
  60. Vapaatalo H. Free radicals and anti-inflammatory drugs. Med Biol. 1986;64:1–7
  61. Deanfield J, Donald A, Ferri C, et al. Endothelial function and dysfunction. Part I: Methodological issues for assessment in the different vascular beds: a statement by the Working Group on Endothelin and Endothelial Factors of the European Society of Hypertension. J Hypertens. 2005;23:7–17
  62. Harrison DG, Cai H, Landmesser U, Griendling KK. Interactions of angiotensin II with NAD(P)H oxidase, oxidant stress and cardiovascular disease. J Renin Angiotensin Aldosterone Syst. 2003;4:51–61
  63. Schulz R, Mahmoudi S, Hattar K, et al. Enhanced release of superoxide from polymorphonuclear neutrophils in obstructive sleep apnea. Impact of continuous positive airway pressure therapy. Am J Respir Crit Care Med. 2000;162:566–570
  64. Dyugovskaya L, Lavie P, Lavie L. Increased adhesion molecules expression and production of reactive oxygen species in leukocytes of sleep apnea patients. Am J Respir Crit Care Med. 2002;165:934–939
  65. Ridker PM, Buring JE, Cook NR, Rifai N. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events. An 8-year follow-up of 14719 initially healthy American women. Circulation. 2003;107:391–397
  66. Danesh J, Whincup P, Walker M, et al. Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses. BMJ. 2000;321:199–204
  67. Hasper D, Hummel M, Kleber FX, Reindl I, Volk HD. Systemic inflammation in patients with heart failure. Eur Heart J. 1998;19:761–765
  68. Vgontzas AN, Papanicolaou DA, Bixler EO, Kales A, Tyson K, Chrousos GP. Elevation of plasma cytokines in disorders of excessive daytime sleepiness: role of sleep disturbance and obesity. J Clin Endocrinol Metab. 1997;82:1313–1316
  69. Woollard KJ, Phillips DC, Griffiths HR. Direct modulatory effect of C-reactive protein on primary human monocytes adhesion to human endothelial cells. Clin Exp Immunol. 2002;130:256–262
  70. Ohga E, Tomita T, Wada H, Yamamoto H, Nagase T, Ouchi Y. Effects of obstructive sleep apnea on circulating ICAM-1, IL-8, and MCP-1. J Appl Physiol. 2003;94:179–184
  71. Ohga E, Nagase T, Tomita T, et al. Increased levels of circulating ICAM-1, VCAM-1,and L-selectin in obstructive sleep apnea syndrome. J Appl Physiol. 1999;87:10–14
  72. Minoguchi K, Yokoe T, Tanaka A, et al. Association between lipid peroxidation and inflammation in obstructive sleep apnoea. Eur Respir J. 2006;28:378–385
  73. Punjabi NM, Sorkin JD, Katzel LI, Goldberg AP, Schwartz AR, Smith PL. Sleep-disordered breathing and insulin resistance in middle-aged and overweight Men. Am J Respir Crit Care Med. 2002;165:677–682
  74. Spiegel K, Leproult R, Van Cauter E. Impact of sleep debt on metabolic and endocrine function. Lancet. 1999;354:1435–1439
  75. Elmasry A, Lindberg E, Berne C, et al. Sleep disordered breathing and glucose metabolism in hypertensive men: a population-based study. J Intern Med. 2001;249:153–161
  76. Vgontzas AN, Papanicolaou DA, Bixler EO, et al. Sleep apnea and daytime sleepiness and fatigue: relation to visceral obesity, insulin resistance, and hypercytokinemia. J Clin Endocrinol Metab. 2000;85:1151–1158
  77. Caro JF, Sinha MK, Kolaczynski JW, Zhang PL, Considine RV. Leptin: the tale of an obesity gene. Diabetes. 1996;45:1455–1462
  78. Wallace AM, McMahon AD, Packard CJ, et al. Plasma leptin and the risk of cardiovascular disease in the West of Scotland Coronary Prevention Study (WOSCOPS). Circulation. 2001;104:3052–3056
  79. Considine RV, Sinha MK, Heiman ML. Serum immunoreactive-leptin concentrations in normal weight and obese humans. N Engl J Med. 1996;334:292–295
  80. Davi G, Guagnano MT, Ciabattoni G. Platelet activation in obese women: role of inflammation and oxidant stress. JAMA. 2002;288:2008–2014
  81. Chin K, Shimizu K, Nakamura T, et al. Changes in intra-abdominal visceral fat and serum leptin levels in patients with obstructive sleep apnea syndrome following nasal continuous positive airway pressure therapy. Circulation. 1999;100:706–712
  82. Elmasry A, Lindberg E, Berne C, et al. Sleep-disordered breathing and glucose metabolism in hypertensive men: a population-based study. J Intern Med. 2001;249:153–161
  83. Bradley TD. Right and left ventricular functional impairment and sleep apnea. Clin Chest Med. 1992;13:459–479
  84. Sajkov D, Cowie RJ, Thornton AT, Espinoza HA, McEvoy RD. Pulmonary hypertension and hypoxemia in obstructive sleep apnea syndrome. Am J Respir Crit Care Med. 1994;149:416–422
  85. Virolainen J, Ventila M, Turto H, Kupari M. Effect of negative intrathoracic pressure on left ventricular pressure dynamics and relaxation. J Appl Physiol. 1995;79:455–460
  86. White SG, Fletcher EC, Miller CC. Acute systemic blood pressure elevation in obstructive and nonobstructive breath hold in primates. J Appl Physiol. 1995;79:324–330
  87. Bixler EO, Vgontzas AN, Lin HM, et al. Association of hypertension and sleep-disordered breathing. Arch Intern Med. 2000;160:2289–2295
  88. Peppard PE, Young T, Palta M. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med. 2000;342:1378–1384
  89. Millman RP, Redline S, Carlisle CC, Assaf AR, Levinson PD. Daytime hypertension in obstructive sleep apnea-prevalence and contributing risk factors. Chest. 1991;99:861–866
  90. Guilleminault C, Simmons FB, Motta H, Cummiskey J, Rosekind M, Schroeder JS. Obstructive sleep apnea syndrome and tracheostomy: long term follow up experience. Arch Intern Med. 1981;141:985–988
  91. Burack B. The hypersomnia-sleep apnea syndrome: its recognition in clinical cardiology. Am Heart J. 1984;107:543–548
  92. Lavie P, Herer P, Hoffstein V. Obstructive sleep apnoea as a risk factor for hypertension: population study. BMJ. 2000;320:479–482
  93. Fletcher EC, Miller J, Schaaf JW, Fletcher JG. Urinary catecholamines before and after tracheostomy in patients with obstructive sleep apnea and hypertension. Sleep. 1987;10:35–44
  94. Baruzzi A, Riva R, Cirignotta F, Zucconi M, Cappelli M, Lugaresi E. Atrial natriuretic peptide and catecholamines in obstructive sleep apnea syndrome. Sleep. 1991;14:83–86
  95. Marrone O, Riccobono L, Salvaggio A, Mirabella A, Bonanno A, Bonsignore MR. Catecholamines and blood pressure in obstructive sleep apnea syndrome. Chest. 1993;103:722–727
  96. Carlson JT, Hedner J, Elam M, Ejnell H, Sellgren J, Wallin BG. Augmented resting sympathetic activity in awake patients with obstructive sleep apnea. Chest. 1993;103:1763–1768
  97. Bazzano LA, Khan Z, Reynolds K, He J. Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension. 2007;50:417–423
  98. Mills PJ, Kennedy BP, Loredo JS, Dimsdale JE, Ziegler MG. Effects of nasal continuous positive airway pressure and oxygen supplementation on norepinephrine kinetics and cardiovascular responses in obstructive sleep apnea. J Appl Physiol. 2006;100:343–348
  99. Faccenda JF, Mackay TW, Boon NA, Douglas NJ. Randomized placebo controlled trial of continuous positive airway pressure on blood pressure in the sleep apnea–hypopnea syndrome. Am J Respir Crit Care Med. 2001;163:344–348
  100. Imadojemu VA, Mawji Z, Kunselman A, Gray KS, Hogeman CS, Leuenberger UA. Sympathetic chemoreflex responses in obstructive sleep apnea and effects of continuous positive airway pressure therapy. Chest. 2007;131:1406–1413
  101. Börgel J, Sanner BM, Keskin F, et al. Obstructive sleep apnea and blood pressure. Interaction between the blood pressure-lowering effects of positive airway pressure therapy and antihypertensive drugs. Am J Hypertens. 2004;17:1081–1087
  102. Minemura H, Akashiba T, Yamamoto H, Akahoshi T, Kosaka N, Horie T. Acute effects of nasal continuous positive airway pressure on 24-hour blood pressure and catecholamines in patients with obstructive sleep apnea. Intern Med. 1998;37:1009–1013
  103. Monasterio C, Vidal S, Duran J, et al. Effectiveness of continuous positive airway pressure in mild sleep apnea hypopnea syndrome. Am J Respir Crit Care Med. 2001;164:939–943
  104. D'Alessandro R, Magelli C, Gamberini G. Snoring every night as a risk factor for myocardial infarction: a case–control study. BMJ. 1990;300:1557–1558
  105. Gami AS, Svatikova A, Wolk R, et al. Cardiac troponin T in obstructive sleep apnea. Chest. 2004;125:2097–2100
  106. Peker Y, Karaiczi H, Hedner J. An independent association between obstructive sleep apnoea and coronary artery disease. Eur Respir J. 1999;14:179–184
  107. Sorajja D, Gami AS, Somers VK, Behrenbeck TR, Garcia-Touchard A, Lopez-Jimenez F. Independent association between obstructive sleep apnea and subclinical coronary artery disease. Chest. 2008;133:927–933
  108. Hanly P, Sasson Z, Zuberi N, Lunn K. ST segment depression during sleep in obstructive sleep apnea. Am J Cardiol. 1993;71:1341–1345
  109. Milleron O, Pilliere R, Foucherb A, et al. Benefits of obstructive sleep apnoea treatment in coronary artery disease: a long-term follow-up study. Eur Heart J. 2004;25:728–734
  110. Mooe T, Franklin KA, Wiklund U. Sleep disordered breathing and myocardial ischemia in patients with coronary artery disease. Chest. 2000;117:1597–1602
  111. Arzt M, Young T, Finn L, et al. Sleepiness and sleep in patients with both systolic heart failure and obstructive sleep apnea. Arch Intern Med. 2006;166:1716–1722
  112. Fung JWH, Li TST, Choy DKL, et al. Severe obstructive sleep apnea is associated with left ventricular diastolic dysfunction. Chest. 2002;121:422–429
  113. Javaheri S, Parker TJ, Liming JD, et al. Sleep apnea in 81 ambulatory male patients with stable heart failure-types and their prevalences, consequences, and presentations. Circulation. 1998;97:2154–2159
  114. Shepard JW, Pevernagie DA, Stanson AW, Daniels BK, Sheedy PF. Effects of changes in central venous pressure on upper airway size in patients with obstructive sleep apnea. Am J Respir Crit Care Med. 1996;153:250–254
  115. Mansfield DR, Gollogly NC, Kaye DM, Richardson M, Bergin P, Naughton MT. Controlled trial of continuous positive airway pressure in obstructive sleep apnea and heart failure. Am J Respir Crit Care Med. 2004;169:361–366
  116. Tanriverdi H, Evrengul H, Kaftan A, et al. Effect of obstructive sleep apnea on aortic elastic parameters relationship to left ventricular mass and function. Circ J. 2006;70:737–743
  117. Tyberg JV, Grant DA, Kingma I, et al. Effects of positive intrathoracic pressure on pulmonary and systemic hemodynamics. Respir Physiol. 2000;119:171–179
  118. Laaban JP, Pascal-Sebaoun S, Bloch E, Orvoën-Frija E, Oppert JM, Huchon G. Left ventricular systolic dysfunction in patients with obstructive sleep apnea syndrome. Chest. 2002;122:1133–1138
  119. Fletcher E, Lesske J, Qian W, Miller CC, Unger T. Repetitive episodic hypoxia causes diurnal elevation of blood pressure in rats. Hypertension. 1992;19:555–561
  120. Parker J, Brooks D, Kozar L, et al. Acute and chronic effects of airway obstruction on canine left ventricular performance. Am J Respir Crit Care Med. 1999;160:1888–1896
  121. Cloward TV, Walker JM, Farney RJ, Anderson JL. Left ventricular hypertrophy is a common echocardiographic abnormality in severe obstructive sleep apnea and reverses with nasal continuous positive airway pressure. Chest. 2003;124:594–601
  122. Hanly P, Sasson Z, Zuberi N, Alderson M. Ventricular function in snorers and patients with obstructive sleep apnea. Chest. 1992;102:100–105
  123. Sanner BM, Konermann M, Sturm A, Müller HJ, Zidek W. Right ventricular dysfunction in patients with obstructive sleep apnoea syndrome. Eur Respir J. 1997;10:2079–2083
  124. Berman EJ, DiBenedetto RJ, Causey DE, et al. Right ventricular hypertrophy detected by echocardiography in patients with newly diagnosed obstructive sleep apnea. Chest. 1991;100:347–350
  125. Chaouat A, Weitzenblum E, Krieger J. Pulmonary hemodynamics in the obstructive sleep apnea syndrome. Results in 220 consecutive patients. Chest. 1996;109:380–386
  126. Alchanatis M, Tourkohoriti G, Kakouros S, Kosmas E, Podaras S, Jordanoglou JB. Daytime hypertension in patients with obstructive sleep apnea: the effect of continuous positive airway pressure on pulmonary hemodynamics. Respiration. 2001;68:566–572
  127. Bady E, Achkar A, Pascal S, Orvoen-Frija E, Laaban JP. Pulmonary arterial hypertension in patients with sleep apnoea syndrome. Thorax. 2000;55:934–939
  128. Nahmias J, Lao R, Karetzky M. Right ventricular dysfunction in obstructive sleep apnoea: reversal with nasal continuous positive airway pressure. Eur Respir J. 1996;9:945–951
  129. Schlosser BM, Walther JW, Rasche K, et al. [Improvement of cardiopulmonary exercise capacity in patients with obstructive sleep apnea syndrome under CPAP therapy]. Med Klin (Munich). 2006;101:107–113
  130. Steiner S, Schueller PO, Schannwell CM, Hennersdorf M, Strauer BE. Effects of continuous positive airway pressure on exercise capacity in chronic heart failure patients without sleep apnea. J Physiol Pharmacol. 2007;58:665–672
  131. Harbison J, O'Reilly P, McNicholas WT. Cardiac rhythm disturbances in the obstructive sleep apnea syndrome-effects of nasal continuous positive airway pressure therapy. Chest. 2000;118:591–595
  132. Serizawa N, Yumino D, Kajimoto K, et al. Impact of sleep-disordered breathing on life-threatening ventricular arrhythmia in heart failure patients with implantable cardioverter–defibrillator. Am J Cardiol. 2008;102:1064–1068
  133. Gami AS, Howard DE, Olson EJ, Somers VK. Day–night pattern of sudden death in obstructive sleep apnea. N Engl J Med. 2005;352:1206–1214
  134. Dolly FR, Block AJ. Increased ventricular ectopy and sleep apnea following ethanol ingestion in COPD patients. Chest. 1983;83:469–472
  135. Gami AS, Pressman G, Caples SM, et al. Association of atrial fibrillation and obstructive sleep apnea. Circulation. 2004;110:364–367
  136. Mooe T, Gullsby S, Rabben T. Sleep-disordered breathing: a novel predictor of atrial fibrillation after coronary artery bypass surgery. Coron Artery Dis. 1996;7:475–478
  137. Jongnarangsin K, Chugh A, Good E, et al. Body mass index, obstructive sleep apnea, and outcomes of catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2008;19:668–672
  138. Kanagala R, Murali NS, Friedman PA, et al. Obstructive sleep apnea and the recurrence of atrial fibrillation. Circulation. 2003;107:2589–2594
  139. Guilleminault C, Connolly SJ, Winkle RA. Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome. Am J Cardiol. 1983;52:490–494
  140. Flemons WW, Remmers JE, Gillis AM. Sleep apnea and cardiac arrhythmias. Is there a relationship?. Am Rev Respir Dis. 1993;148:618–621
  141. Becker H, Brandenburg U, Peter JH, Von-Wichert P. Reversal of sinus arrest and atrioventricular conduction block in patients with sleep apnea during nasal continuous positive airway pressure. Am J Respir Crit Care Med. 1995;151:215–218
  142. Tilkian AG, Guilleminault C, Schroeder JS, Lehrman KL, Simmons FB, Dement WC. Sleep-induced apnea syndrome: prevalence of cardiac arrhythmias and their reversal after tracheostomy. Am J Med. 1977;63:348–358
  143. Koehler U, Fus E, Grimm W, et al. Heart block in patients with obstructive sleep apnoea: pathogenetic factors and effects of treatment. Eur Respir J. 1998;11:434–439
  144. Simantirakis EN, Schiza SI, Marketou ME, et al. Severe bradyarrhythmias in patients with sleep apnoea: the effect of continuous positive airway pressure treatment: a long-term evaluation using an insertable loop recorder. Eur Heart J. 2004;25:1070–1076
  145. Zwillich C, Devlin T, White D, Douglas N, Weil J, Martin R. Bradycardia during sleep apnea characteristics and mechanism. J Clin Invest. 1982;69:1286–1292
  146. Garrigue S, Bordier P, Jais P, et al. Benefit of atrial pacing in sleep apnea syndrome. N Engl J Med. 2002;346:404–412
  147. Spriggs DA, French JM, Murdy JM, Curless RH, Bates D, James OF. Snoring increases the risk of stroke and adversely affects prognosis. QJM. 1992;83:555–562
  148. Partinen M. Ischaemic stroke, snoring and obstructive sleep apnoea. J Sleep Res. 1995;4:156–159
  149. Good DC, Henkle JQ, Gelber D, Welsh J, Verhulst S. Sleep-disordered breathing and poor functional outcome after stroke. Stroke. 1996;27:252–259
  150. Sahlin C, Sandberg O, Gustafson Y, et al. Obstructive sleep apnea is a risk factor for death in patients with stroke—a 10-year follow-up. Arch Intern Med. 2008;168:297–301
  151. Ficker JH, Feistel H, Möller C, et al. Changes in regional CNS perfusion in obstructive sleep apnea syndrome: initial SPECT studies with injected nocturnal 99mTc-HMPAO. Pneumologie. 1997;51:926–930
  152. Netzer N, Werner P, Jochums I, Lehmann M, Strohl KP. Blood flow of the middle cerebral artery with sleep-disordered breathing correlation with obstructive hypopneas. Stroke. 1998;29:87–93
  153. Scala R, Turkington PM, Wanklyn P, Bamford J, Elliott MW. Effects of incremental levels of continuous positive airway pressure on cerebral blood flow velocity in healthy adult humans. Clin Sci (Lond). 2003;104:633–639
  154. Dursunoglu D, Dursunoglu N. Effect of CPAP on QT interval dispersion in obstructive sleep apnea patients with out hypertension. Sleep Med. 2007;8:478–483
  155. Kasai T, Narui K, Dohi T, et al. Prognosis of patients with heart failure and obstructive sleep apnea treated with continuous positive airway pressure. Chest. 2008;133:690–696
  156. Robinson GV, Smith DM, Langford BA, Davies RJ, Stradling JR. Continuous positive airway pressure does not reduce blood pressure in nonsleepy hypertensive OSA patients. Eur Respir J. 2006;27:1229–1235
  157. Becker HF, Jerrentrup A, Ploch T, et al. Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation. 2003;107:68–73
  158. Dorkova Z, Petrasova D, Molcanyiova A, Popovnakova M, Tkacova R. Effects of CPAP on cardiovascular risk profile in patients with severe obstructive sleep apnea and metabolic syndrome. Chest. 2008;134:686–692
  159. Vgontzas AN, Zoumakis E, Bixler EO, et al. Selective effects of CPAP on sleep apnoea-associated manifestations. Eur J Clin Invest. 2008;38:585–595
  160. Kaneko Y, Floras JS, Usui K, et al. Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea. N Engl J Med. 2003;348:1233–1241
  161. Wang H, Parker JD, Newton GE, et al. Influence of obstructive sleep apnea on mortality in patients with heart failure. J Am Coll Cardiol. 2007;49:1625–1631
  162. Weaver TE. Adherence to positive airway pressure therapy. Curr Opin Pulm Med. 2006;12:409–413
  163. Barnes M, McEvoy RD, Banks S, et al. Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea. Am J Respir Crit Care Med. 2004;170:656–664
  164. Hoekema A, Voors AA, Wijkstra PJ, et al. Effects of oral appliances and CPAP on the left ventricle and natriuretic peptides. Int J Cardiol. 2008;128:232–239
  165. Won CH, Li KK, Guilleminault C. Surgical treatment of obstructive sleep apnea: upper airway and maxillomandibular surgery. Proc Am Thorac Soc. 2008;5:193–199
  166. Puhan MA, Suarez A, Lo Cascio C, Zahn A, Heitz M, Braendli O. Didgeridoo playing as alternative treatment for obstructive sleep apnoea syndrome: randomised controlled trial. BMJ. Feb 4 2006;332:266–270
  167. Koh KK, Bui MN, Hathaway L, Csako G, Waclawiw MA, Panza JA. Mechanism by which quinapril improves vascular function in coronary artery disease. Am J Cardiol. 1999;83:327–331
  168. Li-Saw-Hee FL, Beevers DG, Lip GY. Effect of antihypertensive therapy using enalapril or losartan on haemostatic markers in essential hypertension: a pilot prospective randomised double-blind parallel group trial. Int J Cardiol. 2001;78:241–246
  169. Kennon S, Price CP, Mills PG, et al. The effect of aspirin on C-reactive protein as a marker of risk in unstable angina. J Am Coll Cardiol. 2001;37:1266–1270
  170. Albert MA, Danielson E, Rifai N, Ridker PM. Effect of statin therapy on C-reactive protein levels: the pravastatin inflammation/CRP evaluation (PRINCE): a randomized trial and cohort study. JAMA. 2001;286:64–70
  171. Peker Y, Hedner J, Kraiczi H, Loth S. Respiratory Disturbance Index, an independent predictor of mortality in coronary artery disease. Am J Respir Crit Care Med. 2000;162:81–86
  172. Campos-Rodriguez F, Grilo-Reina A, Perez-Ronchel J, et al. Effect of continuous positive airway pressure on ambulatory BP in patients with sleep apnea and hypertension: a placebo-controlled trial. Chest. 2006;129:1459–1467
  173. Hla KM, Skatrud JB, Finn L, Palta M, Young T. The effect of correction of sleep-disordered breathing on BP in untreated hypertension. Chest. 2002;122:1125–1132
  174. Barnes M, Houston D, Worsnop CJ, et al. A randomized controlled trial of continuous positive airway pressure in mild obstructive sleep apnea. Am J Respir Crit Care Med. 2002;165:773–780
  175. Barbe F, Mayoralas LR, Duran J, et al. Treatment with continuous positive airway pressure is not effective in patients with sleep apnea but no daytime sleepiness. A randomized, controlled trial. Ann Intern Med. 2001;134:1015–1023
  176. Campos-Rodriguez F, Perez-Ronchel J, Grilo-Reina A, Lima-Alvarez J, Benitez MA, Almeida-Gonzalez C. Long-term effect of continuous positive airway pressure on BP in patients with hypertension and sleep apnea. Chest. 2007;132:1847–1852
  177. Alchanatis M, Paradellisb G, Pinia H, Tourkohoritia G, Jordanoglou J. Left ventricular function in patients with obstructive sleep apnoea syndrome before and after treatment with nasal continuous positive airway pressure. Respiration. 2000;67:367–371
  178. Miller WP. Cardiac arrhythmias and conduction disturbances in the sleep apnea syndrome: prevalence and significance. Am J Med. 1982;73:317–321
  179. Bolm-Audorff U, Koehler U, Becker E, et al. Nocturnal cardiac arrhythmias in the sleep apnea syndrome. Dtsch Med Wschr. 1984;109:853–856
  180. Arzt M, Young T, Finn L, Skatrud JB, Bradley TD. Association of sleep-disordered breathing and the occurrence of stroke. Am J Respir Crit Care Med. 2005;172:1447–1451
  181. Arias MA, García-Río F, Alonso-Fernández A, Mediano O, Martínez I, Villamor J. Obstructive sleep apnea syndrome affects left ventricular diastolic function: effects of nasal continuous positive airway pressure in men. Circulation. 2005;112:375–383
  182. Coats AJ. Ethical authorship and publishing. Int J Cardiol. 2009;131:149–150

PII: S0167-5273(09)00563-4

doi: 10.1016/j.ijcard.2009.05.021

International Journal of Cardiology
Volume 139, Issue 1 , Pages 7-16 , 18 February 2010

Article Tools

* Image Usage & Resolution