Comorbidity – Sleep Apnea and Cardiac Disease
Obstructive Sleep Apnea has been independently associated with an increased risk of cardiac arrhythmias, hypertension, heart failure, stroke, Type 2 diabetes, and coronary artery disease. A large percentage of patients with OSA remain undiagnosed.
Sleep-disordered breathing (SDB) has been associated with various forms of cardiovascular (CV) disease.
Individuals with severe SDB are two to four times more likely to develop complex arrhythmias than those without SDB. Individuals with diagnosed OSA are between two to three times more likely to develop hypertension, and more likely to suffer a stroke than those without OSA. The prevalence of OSA in patients with heart failure is estimated at 40 to 70 percent. Type 2 diabetes is more prevalent in patients with SDB independent of other risk factors.
Hypertension
Sleep apnea has been associated with the development of hypertension in a dose response relationship. NIH /NHLBI JNC7 recognizes OSA as an identifiable cause of hypertension and recommends screening newly identified hypertensive patients or patients who develop refractory hypertension for OSA.
Heart Failure
ACC/AHA Heart Failure Guidelines recognize OSA as a possible cause for heart failure and recommend screening newly identified heart failure patients for OSA.
Arrhythmias
OSA is associated with a significant risk of atrial fibrillation even after controlling for known confounding parameters. 49 percent of patients with atrial fibrillation have OSA while 32 percent of the general cardiology practice have OSA.