Open AccessSleep apnoea and the heart
Author(s) -
Patrick Lévy,
Silke Ryan,
Olaf Oldenburg,
Gianfranco Parati
Publication year - 2013
Publication title -
european respiratory review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.565
H-Index - 66
eISSN - 1600-0617
pISSN - 0905-9180
DOI - 10.1183/09059180.00004513
Subject(s) - medicine , heart failure , sleep (system call) , hypoxia (environmental) , cardiology , intermittent hypoxia , heart disease , sleep apnea , obstructive sleep apnea , chemistry , organic chemistry , oxygen , computer science , operating system
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.