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Cardiovascular Implications in the Treatment of Obstructive Sleep Apnea

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Abstract

Epidemiological studies provide strong evidence that obstructive sleep apnea (OSA) is associated with cardiovascular complications such as systemic hypertension, congestive heart failure, and atrial fibrillation. Successful OSA treatment with continuous positive airway pressure (CPAP) has resulted in coincident reductions in systemic hypertension, improvements in left ventricular systolic function, and reductions in sympathetic nervous activity. These data suggest that successful treatment of OSA may reduce cardiovascular morbidity in such patients. Although CPAP is the more successful treatment for OSA when used properly and consistently, its clinical success is often limited by poor patient and partner acceptance, which leads to suboptimal compliance. Oral appliances or upper airway surgeries are considered a second line of treatment for patients with mild to moderate OSA who do not comply with or refuse long-term CPAP treatment. Oral devices such as mandibular repositioning appliances were recently shown to improve arterial hypertension in OSA patients. Electrical stimulation of the hypoglossal nerve is a new investigational therapy for patients with moderate to severe OSA. This new treatment option, if proven effective, may provide cardiovascular benefits secondary to treating OSA.

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Authors and Affiliations

  1. Department of ENT, Head and Neck Surgery, University of Antwerp, University Hospital Antwerp, Wilrijkstraat 10, 2650, Edegem, Antwerp, Belgium

    Olivier M. Vanderveken, An Boudewyns & Paul Van de Heyning

  2. Inspire Medical Systems, Inc., Maple Grove, MN, 55369, USA

    Quan Ni & Bhavani Kashyap

  3. Department of Pulmonary Medicine, University of Antwerp, University Hospital Antwerp, Wilrijkstraat 10, 2650, Edegem, Antwerp, Belgium

    Johan Verbraecken & Wilfried De Backer

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  1. Olivier M. Vanderveken
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  2. An Boudewyns
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Correspondence to Olivier M. Vanderveken.

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Vanderveken, O.M., Boudewyns, A., Ni, Q. et al. Cardiovascular Implications in the Treatment of Obstructive Sleep Apnea. J. of Cardiovasc. Trans. Res. 4, 53–60 (2011). https://doi.org/10.1007/s12265-010-9238-y

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