Advertisement

Somnologie

, 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
Leserbriefe
  • 15 Downloads

Reply

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.  https://doi.org/10.1007/s11818-019-0212-x

Original version

Biener L, Pizarro C, Nickenig G, Skowasch D (2019) Obstructive sleep apnea and atherosclerosis—update 2019. Somnologie 23:3–7.  https://doi.org/10.1007/s11818-019-0194-8

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...

Abbreviations

ACC

American College of Cardiology

AHI

Apnea–hypopnea index

CPAP

Continuous positive airway pressure

CVD

Cardiovascular disease

ESC

European Society of Cardiology

MACE

Major adverse cardiovascular event

OSA

Obstructive sleep apnea

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

Notes

Conflict of interest

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

References

  1. 1.
    Savransky V, Nanayakkara A, Li J, Bevans S, Smith PL, Rodriguez A et al (2007) Chronic intermittent hypoxia induces atherosclerosis. Am J Respir Crit Care Med 175(12):1290–1297CrossRefGoogle Scholar
  2. 2.
    Drager LF, Bortolotto LA, Lorenzi MC, Figueiredo AC, Krieger EM, Lorenzi-Filho G (2005) Early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med 172(5):613–618CrossRefGoogle Scholar
  3. 3.
    Drager LF, Bortolotto LA, Figueiredo AC, Krieger EM, Lorenzi GF (2007) Effects of continuous positive airway pressure on early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med 176(7):706–712CrossRefGoogle Scholar
  4. 4.
    Xie C, Zhu R, Tian Y, Wang K (2017) Association of obstructive sleep apnoea with the risk of vascular outcomes and all-cause mortality: a meta-analysis. BMJ Open 7(12):e13983CrossRefGoogle Scholar
  5. 5.
    Gami AS, Howard DE, Olson EJ, Somers VK (2005) Day-night pattern of sudden death in obstructive sleep apnea. N Engl J Med 352(12):1206–1214CrossRefGoogle Scholar
  6. 6.
    Mansukhani MP, Wang S, Somers VK (2015) Sleep, death, and the heart. Am J Physiol Heart Circ Physiol 309(5):H739–H749CrossRefGoogle Scholar
  7. 7.
    Becker HF, Jerrentrup A, Ploch T, Grote L, Penzel T, Sullivan CE et al (2003) Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation 107(1):68–73CrossRefGoogle Scholar
  8. 8.
    Arzt M, Floras JS, Logan AG, Kimoff RJ, Series F, Morrison D et al (2007) Suppression of central sleep apnea by continuous positive airway pressure and transplant-free survival in heart failure: a post hoc analysis of the Canadian Continuous Positive Airway Pressure for Patients with Central Sleep Apnea and Heart Failure Trial (CANPAP). Circulation 115(25):3173–3180CrossRefGoogle Scholar
  9. 9.
    Weaver TE, Maislin G, Dinges DF, Bloxham T, George CF, Greenberg H et al (2007) Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning. Sleep 30(6):711–719CrossRefGoogle Scholar
  10. 10.
    Peker Y, Glantz H, Eulenburg C, Wegscheider K, Herlitz J, Thunstrom E (2016) Effect of positive airway pressure on cardiovascular outcomes in coronary artery disease patients with Nonsleepy obstructive sleep apnea. The RICCADSA randomized controlled trial. Am J Respir Crit Care Med 194(5):613–620CrossRefGoogle Scholar
  11. 11.
    McEvoy RD, Antic NA, Heeley E, Luo Y, Ou Q, Zhang X et al (2016) CPAP for prevention of cardiovascular events in obstructive sleep apnea. N Engl J Med 375(10):919–931CrossRefGoogle Scholar
  12. 12.
    Whelton PK, Carey RM, Aronow WS, Casey DE Jr., Collins KJ, Dennison Himmelfarb C et al (2018) 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American college of cardiology/American heart association task force on clinical practice guidelines. J Am Coll Cardiol 71(19):e127–e248CrossRefGoogle Scholar
  13. 13.
    Borgel J, Springer S, Ghafoor J, Arndt D, Duchna HW, Barthel A et al (2010) Unrecognized secondary causes of hypertension in patients with hypertensive urgency/emergency: prevalence and co-prevalence. Clin Res Cardiol 99(8):499–506CrossRefGoogle Scholar
  14. 14.
    Zhou X, Liu F, Zhang W, Wang G, Guo D, Fu W et al (2018) Obstructive sleep apnea and risk of aortic dissection: a meta-analysis of observational studies. Vascular 26(5):515–523CrossRefGoogle Scholar
  15. 15.
    Braga B, Poyares D, Cintra F, Guilleminault C, Cirenza C, Horbach S et al (2009) Sleep-disordered breathing and chronic atrial fibrillation. Sleep Med 10(2):212–216CrossRefGoogle Scholar
  16. 16.
    Naruse Y, Tada H, Satoh M, Yanagihara M, Tsuneoka H, Hirata Y et al (2013) Concomitant obstructive sleep apnea increases the recurrence of atrial fibrillation following radiofrequency catheter ablation of atrial fibrillation: clinical impact of continuous positive airway pressure therapy. Heart Rhythm 10(3):331–337CrossRefGoogle Scholar
  17. 17.
    Fox H, Bitter T, Horstkotte D, Oldenburg O (2016) Cardioversion of atrial fibrillation or atrial flutter into sinus rhythm reduces nocturnal central respiratory events and unmasks obstructive sleep apnoea. Clin Res Cardiol 105(5):451–459CrossRefGoogle Scholar
  18. 18.
    Gami AS, Pressman G, Caples SM, Kanagala R, Gard JJ, Davison DE et al (2004) Association of atrial fibrillation and obstructive sleep apnea. Circulation 110(4):364–367CrossRefGoogle Scholar
  19. 19.
    Neilan TG, Farhad H, Dodson JA, Shah RV, Abbasi SA, Bakker JP et al (2013) Effect of sleep apnea and continuous positive airway pressure on cardiac structure and recurrence of atrial fibrillation. J Am Heart Assoc 2(6):e421CrossRefGoogle Scholar
  20. 20.
    Matiello M, Nadal M, Tamborero D, Berruezo A, Montserrat J, Embid C et al (2010) Low efficacy of atrial fibrillation ablation in severe obstructive sleep apnoea patients. Europace 12(8):1084–1089CrossRefGoogle Scholar
  21. 21.
    Taranto-Montemurro L, Messineo L, Sands SA, Azarbarzin A, Marques M, Edwards BA et al (2018) The combination of Atomoxetine and Oxybutynin greatly reduces obstructive sleep apnea severity: a randomized, placebo-controlled, double-blind crossover trial. Am J Respir Crit Care Med 199(10):1267–1276.  https://doi.org/10.1164/rccm.201808-1493OC CrossRefGoogle Scholar

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

Personalised recommendations