Obstructive sleep apnea. Implications for the cardiologist Review article
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Abstract
Cardiovascular researches recently focus our interests on sleep issues. Sleep deprivation caused by recurrent episodes of apnea may precipitate cardiovascular disease. Unsocial, loud snoring with periods of cessation of breathing has been recognized as an independent risk factor for arterial hypertension, ischemic heart disease and stroke. Untreated sleep apnea results in deterioration of left ventricle function and precipitates occurrence of cardiac arrhythmias. It has been also well established that central sleep apnea accompanies failing heart where it may worsen outcome. The most important message out of numbers of research is amelioration of cardiovascular condition soon after introduction of CPAP therapy.
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References
2. Stokes W.: The diseases of the heart and the aorta. Dublin Hodges and Smith 1854: 323-324 (wyimki).
3. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 1999, 22: 667-689.
4. Young T., Palta M., Dempsey J., Skarrud J., Weber S., Badr S.: The occurrence of sleep-disordered breathing among middle-aged adults. N. Engl. J. Med. 1993, 328: 1230-1235.
5. Pływaczewski R., Bednarek M., Jonczak L., Zieliński J.: Sleep-disordered breathing in a middle-aged and older Polish urban population. J. Sleep Res. 2008,17: 73-81.
6. Brooks D., Horner R.L., Kozar L.F., Render-Teixeira C.L., Phillipson E.A.: Obstructive sleep apnea as a cause of systemic hypertension. Evidence from a canine model. J. Clin. Invest. 1997, 99: 106-109.
7. Bixler E.O., Vgontzas A.N., Lin H.M., Ten Have T., Leiby B.E., Vela-Bueno A., Kales A.: Association of hypertension and sleep-disordered breathing. Arch. of Intern. Med. 2000, 160: 2289-2295.
8. Young T., Peppard P., Palta M., Hla K.M., Finn L., Morgan B., Skatrud J.: Population-based study of sleep-disordered breathing as a risk factor for hypertension. Arch. Intern. Med. 1997, 157: 1746-1752.
9. Nieto F.J., Young T.B., Bonnie K.L., Shahar E., Samet J.M., Redline S., D’Agostino R.B., Newman A.B., Lebowitz M., Pickering T.C. (for the Sleep Heart Health Study): Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. JAMA 2000, 283: 1829-1836.
10. Logan A.G., Perlikowski S.M., Mente A., Tisler A., Tkacova R., Niroumand M., Leung R.S., Bradley T.D.: High prevalence of unrecognized sleep apnoea in drug-resistant hypertension. J. Hypertens. 2001, 19: 2271-2277.
11. Somers V.K., Dyken M.E., Clary M.P., Abboud F.M.: Sympathetic neural mechanisms in obstructive sleep apnea. J. Clin. Invest. 1995, 96: 1897-1904.
12. Dolan E., Stanton A., Thijs L., Hinedi K., Atkins N., Mc- Clory S., Den Hond E., McCormack P., Staessen J.A., O’Brien E.: Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: the Dublin outcome study. Hypertension 2005, 46: 156-161.
13. Fagard R.H., Celis H., Thijs L., Staessen J.A., Clement D.L., De Buyzere M.L., De Bacquer D.A.: Daytime and nighttime blood pressure as predictors of death and cause-specific cardiovascular events in hypertension. Hypertension 2008, 51: 55-61.
14. Sega R., Facchetti R., Bombelli M., Cesana G., Corrao G., Grassi G., Mancia G.: Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population: follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. Circulation 2005, 111: 1777-1783.
15. Kikuya M., Ohkubo T., Asayama K., Metoki H., Obara T., Saito S., Hashimoto J., Totsune K., Hoshi H., Satoh H., Imai Y.: Ambulatory blood pressure and 10-year risk of cardiovascular and noncardiovascular mortality: the Ohasama study. Hypertension 2005, 45: 240-245.
16. Baguet J.P., Lévy P., Barone-Rochette G., Tamisier R., Pierre H., Peeters M., Mallion J.M., Pépin J.L.: Masked hypertension in obstructive sleep apnea syndrome. J. Hypertens. 2008, 26: 885-892.
17. Peppard P.E., Young T., Palta M., Skatrud J.: Prospective study of the association between sleep-disordered breathing and hypertension. N. Engl. J. Med. 2000, 342: 1378-1784.
18. Haas D.C., Foster G.L., Nieto F.J., Redline S., Resnick H.E., Robbins J.A., Young T., Pickering T.G.: Age-dependent associations between sleep-disordered breathing and hypertension: importance of discriminating between systolic/diastolic hypertension and isolated systolic hypertension in the Sleep Heart Health Study. Circulation 2005, 111: 614-621.
19. Guilleminault C., Khramsov A., Stoohs R.A., Kushida C., Pelayo R., Kreutzer M.L., Chowdhuri S.: Abnormal blood pressure in prepubertal children with sleepdisordered breathing. Pediatr. Res. 2004, 55: 76-84.
20. Leung L.C., Ng D.K., Lau M.W., Chan C.H., Kwok K.L., Chow P.Y., Cheung J.M.: Twenty-four-hour ambulatory BP in snoring children with obstructive sleep apnea syndrome. Chest 2006, 130: 1009-1017.
21. Li A.M., Au C.T., Sung R.Y., Ho C., Ng P.C., Fok T.F., Wing Y.K.: Ambulatory Blood Pressure in Children with Obstructive Sleep Apnoea - A Community Based Study. Thorax 2008 (w druku).
22. Wilcox I., Grunstein R.R., Hedner J.A. et al.: Effect of nasal continuous positive airway pressure during sleep on 24-hour blood pressure in obstructive sleep apnea. Sleep 1993, 16: 539-44.
23. Pepperell J.C., Ramdassingh-Dow S., Crosthwaite N. et al.: Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet 2002, 359: 204-210.
24. Becker H.F., Jerrentrup A., Ploch T. et al.: Effect of Nasal Continuous Positive Airway Pressure Treatment on Blood Pressure in Patients With Obstructive Sleep Apnea. Circulation 2003, 107: 68-73.
25. Tilkian A.G., Guilleminault C., Schroeder J.S., Lehrman K.L., Simmons F.B., Dement W.C.: Sleep-induced apnea syndrome. Prevalence of cardiac arrhythmias and their reversal after tracheostomy. Am. J. Med. 1977, 63: 348-358.
26. Zwillich C., Devlin T., White D., Douglas N., Weil J., Martin R.: Bradycardia during sleep apnea. Characteristics and mechanism. J. Clin. Invest. 1982, 69: 1286-1292.
27. Becker H.F., Koehler U., Stammnitz A., Peter J.H.: Heart block in patients with sleep apnoea. Thorax 1998, 53 (supl. 3): S29-32.
28. Garrigue S., Pépin J.L., Defaye P., Murgatroyd F., Poezevara Y., Clémenty J., Lévy P.: High prevalence of sleep apnea syndrome in patients with long-term pacing: the European Multicenter Polysomnographic Study. Circulation 2007, 115: 1703-1709.
29. Guilleminault C., Connolly S.J., Winkle R.A.: Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome. Am. J. Cardiol. 1983, 52: 490-4 (abstrakt).
30. Flemons W.W., Remmers J.E., Gillis A.M.: Sleep apnea and cardiac arrhythmias. Is there a relationship? Am. Rev. Respir. Dis. 1993, 148(3): 618-21.
31. Mooe T., Franklin K.A., Wiklund U., Rabben T., Holmstrom K.: Cardiac rhythm in patients with sleep-disordered breathing and coronary artery disease. Scand. Cardiovasc. J. 2000, 34: 272-6.
32. Shepard J.W. jr, Garrison M.W., Grither D.A., Dolan G.F.: Relationship of ventricular ectopy to oxyhemoglobin desaturation in patients with obstructive sleep apnea. Chest 1985, 88: 335-40.
33. Valencia-Flores M., Orea A., Castano V.A., Resendiz M., Rosales M., Rebollar V., Santiago V., Gallegos J., Campos R.M., Gonzalez J., Oseguera J., Garcýa-Ramos G., Bliwise D.L.: Prevalence of sleep apnea and electrocardiographic disturbances in morbidly obese patients. Obes. Res. 2000, 8: 262-9.
34. Fichter J., Bauer D., Arampatzis S., Fries R., Heisel A., Sybrecht G.W.: Sleep-Related Breathing Disorders Are Associated With Ventricular Arrhythmias in Patients With an Implantable Cardioverter-Defibrillator. Chest 2002, 122: 558-561.
35. Mehra R., Benjamin E.J., Sahar E., Gottlieb D.J., Nawabit R., Kirchner H.L., Sahadevan J., Redline S.: Association of Nocturnal Arrhythmias with Sleep-disordered Breathing. The Sleep Heart Health Study. Am. J. Respir. Crit. Care Med. 2006, 173: 910-916.
36. Harbison J., O’Reilly P., McNicholas W.T.: Cardiac Rhythm Disturbances in the Obstructive Sleep Apnea Syndrome. Effects of Nasal Continuous Positive Airway Pressure Therapy. Chest 2000, 118: 591-595.
37. Ryan C.M., Usui K., Floras J.S., Bradley T.D.: Effect of continuous positive airway pressure on ventricular ectopy in heart failure patients with obstructive sleep apnoea. Thorax 2005, 60: 781-5.
38. Gami A.S., Howard D.E., Olson E.J., Somers V.K.: Daynight pattern of sudden death in obstructive sleep apnea. N. Engl. J. Med. 2005, 352: 1206-14.
39. Porthan K.M., Melin J.H., Kupila J.T. et al.: Prevalence of Sleep Apnea Syndrome in Lone Atrial Fibrillation. Chest 2004, 125: 879-885.
40. Gami A.S., Pressman G., Caples S.M., Kanagala R., Gard J.J., Davison D.E., Malouf J.F., Ammash N.M., Friedman P.A., Somers V.K.: Association of Atrial Fibrillation and Obstructive Sleep Apnea. Circulation 2004, 110: 364-367.
41. Stevenson I.H., Teichtahl H., Cunnington D., Ciavarella S., Gordon I., Kalman J.M.: Prevalence of sleep disordered breathing in paroxysmal and persistent atrial fibrillation patients with normal left ventricular function. Eur. Heart J. 2008 May 30 (w druku, streszczenie).
42. Kanagala R., Murali N.S., Friedman P.A. et al.: Obstructive sleep apnea and the recurrence of atrial fibrillation. Circulation 2003, 107: 2589-2594.
43. Jongnarangsin K., Chugh A., Good E., Mukerji S., Dey S., Crawford T., Sarrazin J.F., Kuhne M., Chalfoun N., Wells D., Boonyapisit W., Pelosi F. jr, Bogun F., Morady F., Oral H.: Body Mass Index, Obstructive Sleep Apnea, and Outcomes of Catheter Ablation of Atrial Fibrillation. J. Cardiovasc. Electrophysiol. 2008 Mar 20 (w druku, streszczenie).
44. Fuster V., Ryden L.E., Asinger R.W. et al.: ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: executive summary, a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation) developed in collaboration with the North American Society of Pacing and Electrophysiology. Circulation 2001, 104: 2118-2150.
45. Hung J., Whitford E.G., Parsons R.W., Hillman D.R.: Association of sleep apnoea with myocardial infarction in men. Lancet 1990, 336: 261-264.
46. Mooe T., Rabben T., Wiklund U., Franklin K.A., Eriksson P.: Sleep-disordered breathing in women: occurrence and association with coronary artery disease. Am. J. Med. 1996, 101: 251-256.
47. Peled N., Abinader E.G., Pillar G., Sharif D., Lavie P.: Nocturnal Ischemic Events in Patients With Obstructive Sleep Apnea Syndrome and Ischemic Heart Disease Effects of Continuous Positive Air Pressure Treatment. J. Am. Coll. Cardiol. 1999, 34: 1744-1749.
48. Shahar E., Whitney C.W., Redline S., Lee E.T., Newman A.B., Nieto F.J., O’Connor G.T., Boland L.L., Schwartz J.E., Samet J.M.: Sleep-disordered Breathing and Cardiovascular Disease. Cross-sectional Results of the Sleep Heart Health Study. Am. J. Respir. Crit. Care Med. 2001, 163: 19-25.
49. Peker Y., Kraiczi H., Hedner J., Löth S., Johansson A., Bende M.: An independent association between obstructive sleep apnoea and coronary artery disease. Eur. Respir. J. 1999, 13: 179-184.
50. Kraiczi H., Peker Y., Caidahl K., Samuelsson A., Hedner J.: Blood pressure, cardiac structure and severity of obstructive sleep apnea in a sleep clinic population. J. Hypertens. 2001, 19: 2071-2078.
51. Tanriverdi H., Evrengul H., Kaftan A., Kara C.O., Kuru O., Tanriverdi S., Ozkurt S., Semiz E.: Effect of Obstructive Sleep Apnea on Aortic Elastic Parameters – Relationship to Left Ventricular Mass and Function. Circ. J. 2006, 70: 737-743.
52. Peker Y., Hedner J., Kraiczi H., Löth S.: Respiratory disturbance index – an independent predictor of mortality in coronary artery disease. Am. J. Respir. Crit. Care. Med 2000, 162: 81-86.
53. Mooe T., Franklin K.A., Holmstrom K., Rabben T., Wiklund U.: Sleep disordered breathing and coronary artery disease: long-term prognosis. Am. J. Respir. Crit. Care. Med. 2001, 164: 1910-1913.
54. Milleron O., Pilliere R., Foucher A., de Roquefeuil F., Aegerter P., Jondeau G., Raffestin B.G., Dubourg O.: Benefits of obstructive sleep apnoea treatment in coronary artery disease: a long-term followup study. Eur. Heart J. 2004, 25: 728-734.
55. Fung J.W.H., Li T.S.T., Choy D.K.L., Yip G.W.K., Ko F.W.S., Sanderson J.E., Hui D.S.C.: Severe obstructive sleep Apnea is associated with left ventricular diastolic dysfunction. Chest 2002, 121: 422-429.
56. Parker J.D., Brooks D., Kozar L.F., Render-Teixeira C.L., Horner R.L., Bradley T.D., Phillipson E.A.: Acute and Chronic Effects of Airway Obstruction on Canine Left Ventricular Performance. Am. J. Respir. Crit. Care. Med. 1999, 160: 1888-1896.
57. Alchanatis M., Tourkohoriti G., Kosmas E.N., Panoutsopoulos G., Kakouros S., Papadima K., Gaga M., Jordanoglou J.B.: Evidence for left ventricular dysfunction in patients with obstructive sleep apnoea syndrome. Eur. Respir. J. 2002, 20: 1239-1245.
58. Laaban J.P., Pascal- Sebaoun S., Bloch E., Orvoën-Frija E., Oppert J.M., Huchon G.: Left Ventricular Systolic Dysfunction in Patients With Obstructive Sleep Apnea Syndrome. Chest 2002, 122: 1133-1138.
59. Chami H.A., Devereux R.B., Gottdiener J.S., Mehra R., Roman M.J., Benjamin E.J., Gottlieb D.J.: Left ventricular morphology and systolic function in sleep-disordered breathing: the Sleep Heart Health Study. Circulation 2008, 117: 2599-2607.
60. Hall M.J., Ando S., Floras J.S., Bradley T.D.: Magnitude and time course of hemodynamic responses to Mueller maneuvers in patients with congestive heart failure. J. Appl. Physiol. 1998, 85: 1476-1484.
61. Lanfranchi P.A., Braghiroli A., Bosimini E., Mazzuero G., Colombo R., Donner C.F., Giannuzzi P.: Prognostic value of nocturnal Cheyne-Stokes respiration in chronic heart failure. Circulation 1999, 99: 1435-1440.
62. Hanly P.J., Zuberi- Khokhar N.S.: Increased mortality associated with Cheyne-Stokes respiration in patients with congestive heart failure. Am. J. Respir. Crit. Care. Med. 1996, 153: 272-276 (streszczenie).
63. Garrigue S., Bordier P., Jaďs P., Shah D.C., Hocini M., Raherison C., Tunon De Lara M., Haďssaguerre M., Clementy J.: Benefit of atrial pacing in sleep apnea syndrome. N. Engl. J. Med. 2002, 346: 404-412.
64. Arzt M., Floras J.S., Logan A.G., Kimoff R.J., Series F., Morrison D., Ferguson K., Belenkie I., Pfeifer M., Fleetham J., Hanly P., Smilovitch M., Ryan C., Tomlinson G., Bradley T.D. (CANPAP Investigators) 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 2007, 115: 3173-3180.
65. Shahar E., Whitney C.W., Redline S., Lee E.T., Newman A.B., Nieto F.J., O’Connor G.T., Boland L.L., Schwartz J.E., Samet J.M.: Sleep-disordered Breathing and Cardiovascular Disease. Cross-sectional Results of the Sleep Heart Health Study. Am. J. Respir. Crit. Care. Med. 2001, 163: 19- 25.
66. Yaggi H.K., Concato J., Kernan W.N., Lichtman J.H., Brass L.M., Mohsenin V.: Obstructive sleep apnea as a risk factor for stroke and death. N. Engl. J. Med. 2005, 353: 2034-2041.
67. Parra O., Arboix A., Bechich S., Garcia-Eroles L., Montserrat J.M., Lopez J.A., Ballester E., Guerra J.M., Sopena J.J.: Time course of sleep-related breathing disorders in first-ever stroke or transient ischemic attack. Am. J. Respir. Crit. Care. Med. 2000, 161: 375-380.
68. Martinez-Garcia M.A., Galiano-Blancart R., Roman-Sanchez P., Soler-Cataluna J.J., Cabero-Salt L., Salcedo-Maiques E.: Continuous positive airway pressure treatment in sleep apnea prevents new vascular events after ischemic stroke. Chest 2005, 128: 2123-2129.
69. Raabe A., Grolms C., Sorge O., Zimmermann M., Seifert V.: Serum S-100B protein in severe head injury. Neurosurgery 1999, 45: 477-483.
70. Raabe A., Grolms C., Keller M., Döhnert J., Sorge O., Seifert V.: Correlation of computed tomography findings and serum brain damage markers following severe head injury. Acta Neurochir. 1998, 140: 787-791 (streszczenie).
71. Braga C.W., Martinez D., Wofchuk S., Portela L.V., Souza D.O.: S100B and NSE serum levels in obstructive sleep apnea syndrome. Sleep Med. 2006, 7: 431-435.
72. Sonka K., Kelemen J., Kemlink D., Volná J., Pretl M., Zima T., Benakova H., Rambousek P., Foltán R., Donev F.: Evening and morning plasma levels of protein S100B in patients with obstructive sleep apnea. Neuro. Endocrinol. Lett. 2007, 28: 575-579 (streszczenie).
73. Chesson A.L. et al.: ASDA Standards of Practice Committee. Practice parameters for the indications for polysomnography and related procedures. Sleep 1997, 20: 406-22.
74. Littner M.R., Shepard J.W.: Recommendations for research into measurement and classification of sleep disordered breathing: gazing into the crystal ball. Sleep 1999, 22: 665-6.
75. Netzer N.C., Stoohs R.A., Netzer C.M. et al.: Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann. Intern. Med. 1999, 131: 485-91.
76. Johns M.W.: A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991, 14: 540- 5.
77. Logan A.G., Perlikowski S.M., Mente A., Tisler A., Tkacova R., Niroumand M., Leung R.S., Bradley T.D.: High prevalence of unrecognized sleep apnoea in drug-resistant hypertension. J. Hypertens. 2001, 19: 2271-2277.
78. Szczepańska E.: Chirurgiczne leczenie otyłości. Endokrynologia Polska 2004, 3: 308-10.