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The importance of sleep-disordered breathing in cardiovascular disease

Abstract

Obstructive sleep apnoea and central sleep apnoea/Cheyne-Stokes respiration are collectively referred to as sleep-disordered breathing (SDB). Rapidly accumulating evidence suggests that both forms of SDB, and often a combination of both, are highly prevalent in patients with a wide variety of cardiovascular diseases, including hypertension, heart failure, arrhythmias, coronary artery disease, acute coronary syndrome and stroke. The presence of SDB in these patients is independently associated with worse cardiac function and exercise tolerance, recurrent arrhythmias, infarct expansion, decreased quality of life and increased mortality. Recent data suggest positive effects of positive airway pressure (PAP) therapy on quality of life and cardiovascular function. In addition, ongoing clinical trials may soon provide first definitive data on PAP therapy of SDB on hard outcomes such as mortality. This review presents current data highlighting links between SDB and a variety of cardiovascular conditions, the importance of recognising and diagnosing SDB in patients with cardiovascular disease, and the effects of effective SDB treatment on cardiovascular endpoints.

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Acknowledgments

D. L. is supported by HOMFOR 2013/2014, the Else Kröner-Fresenius Foundation and the Deutsche Gesellschaft für Kardiologie. Medical writing support was provided by Nicola Ryan, independent medical writer, on behalf of ResMed. MRC’s salary is supported by the NIHR Cardiovascular Biomedical Research Unit at the Royal Brompton Hospital, London.

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Linz, D., Woehrle, H., Bitter, T. et al. The importance of sleep-disordered breathing in cardiovascular disease. Clin Res Cardiol 104, 705–718 (2015). https://doi.org/10.1007/s00392-015-0859-7

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Keywords

  • Obstructive sleep apnoea
  • Central sleep apnoea
  • Cheyne-Stokes respiration
  • Cardiovascular disease
  • Atrial fibrillation
  • Mortality