title: Sleep Apnea: Types, Mechanisms, and Clinical Cardiovascular Consequences.
abstract: Sleep apnea is highly prevalent in patients with cardiovascular disease. These disordered breathing events are associated with a profile of perturbations that include intermittent hypoxia, oxidative stress, sympathetic activation, and endothelial dysfunction, all of which are critical mediators of cardiovascular disease. Evidence supports a causal association of sleep apnea with the incidence and morbidity of hypertension, coronary heart disease, arrhythmia, heart failure, and stroke. Several discoveries in the pathogenesis, along with developments in the treatment of sleep apnea, have accumulated in recent years. In this review, we discuss the mechanisms of sleep apnea, the evidence that addresses the links between sleep apnea and cardiovascular disease, and research that has addressed the effect of sleep apnea treatment on cardiovascular disease and clinical endpoints. Finally, we review the recent development in sleep apnea treatment options, with special consideration of treating patients with heart disease. Future directions for selective areas are suggested.
authors.affiliation: Pulmonary and Sleep Division, Bethesda North Hospital, Cincinnati, Ohio. Electronic address: shahrokhjavaheri@icloud.com.
authors.forename: Shahrokh
authors.initials: S
authors.lastname: Javaheri
authors.affiliation: Respiratory Department, Institut Ricerca Biomèdica de Lleida, Hospital Universitari Arnau de Vilanova, Lleida, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Barbe
authors.affiliation: Respiratory Department, Hospital Universitario de Valme, Sevilla, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Campos-Rodriguez
authors.affiliation: Department of Population Health Sciences and John Rankin Laboratory of Pulmonary Medicine, University of Wisconsin-Madison, Madison, Wisconsin.
authors.forename: Jerome A
authors.initials: JA
authors.lastname: Dempsey
authors.affiliation: Sleep Heart Program, the Ohio State University, Columbus, Ohio.
authors.forename: Rami
authors.initials: R
authors.lastname: Khayat
authors.affiliation: Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Sogol
authors.initials: S
authors.lastname: Javaheri
authors.affiliation: Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego, California.
authors.forename: Atul
authors.initials: A
authors.lastname: Malhotra
authors.affiliation: Respiratory Department, Hospital Universitario de Politecnico La Fe, Valencia, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Martinez-Garcia
authors.affiliation: Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Reena
authors.initials: R
authors.lastname: Mehra
authors.affiliation: Division of Sleep Medicine/Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Allan I
authors.initials: AI
authors.lastname: Pack
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Vsevolod Y
authors.initials: VY
authors.lastname: Polotsky
authors.affiliation: Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts; Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Susan
authors.initials: S
authors.lastname: Redline
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Virend K
authors.initials: VK
authors.lastname: Somers
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology*; D006801:Humans; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy
keywords: central sleep apnea; hypertension; obstructive sleep apnea