, Volume 23, Issue 4, pp 318–319 | Cite as

Obstructive sleep apnea and cardiovascular disease: a cause more silent than apparent?

  • Sven StieglitzEmail author
  • Hans Jürgen Heppner
  • Antonio Esquinas


This reply refers to Biener L, Pizarro C, Nickenig G, Skowasch D (2019) Obstructive sleep apnea and cardiovascular disease: a cause apparent but not yet evident. Somnologie.

Original version

Biener L, Pizarro C, Nickenig G, Skowasch D (2019) Obstructive sleep apnea and atherosclerosis—update 2019. Somnologie 23:3–7.

Leonie Biener et al. reviewed the literature with regard to obstructive sleep apnea and atherosclerosis (Somnologie 1/2019). The conclusion of the report was that there is an association between obstructive sleep apnea (OSA), cardiovascular disease, and sleep apnea. Nevertheless, the authors questioned a causative relationship between OSA and cardiovascular disease. The main argumentation is the failure of clinical studies to show an improvement of cardiovascular endpoints by continuous positive airway pressure (CPAP) therapy.

In animal studies, OSA is able to induce arteriosclerosis...



American College of Cardiology


Apnea–hypopnea index


Continuous positive airway pressure


Cardiovascular disease


European Society of Cardiology


Major adverse cardiovascular event


Obstructive sleep apnea

Obstruktive Schlafapnoe und Herz-Kreislauf-Erkrankungen – als Ursache eher subtil denn offensichtlich?


Conflict of interest

S. Stieglitz, H.J. Heppner, and A. Esquinas declare that they have no competing interests.


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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • Sven Stieglitz
    • 1
    Email author
  • Hans Jürgen Heppner
    • 2
  • Antonio Esquinas
    • 3
  1. 1.Department of Pneumology, Allergy, Sleep and Intensive Care MedicinePetrus Hospital WuppertalWuppertalGermany
  2. 2.Helios Clinic Schwelm, Department of Geriatrics; Chair of geriatric medicineUniversity Witten/HerdeckeWittenGermany
  3. 3.Intensive Care UnitHospital Morales MeseguerMurciaSpain

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