Manuscript received 10 March 2007; Revised manuscript received 30 March 2007; Accepted for publication 3 April 2007.
Obstructive Sleep Apnea and its Relationship to Cardiac Arrhythmias
Article first published online: 27 JUL 2007
Journal of Cardiovascular Electrophysiology
Volume 18, Issue 9, pages 1006–1014, September 2007
How to Cite
ARIAS, M. A. and SÁNCHEZ, A. M. (2007), Obstructive Sleep Apnea and its Relationship to Cardiac Arrhythmias. Journal of Cardiovascular Electrophysiology, 18: 1006–1014. doi: 10.1111/j.1540-8167.2007.00891.x
Editor: Stephen C. Hammill, M.D.
- Issue published online: 27 JUL 2007
- Article first published online: 27 JUL 2007
- sleep apnea;
- supraventricular tachycardia;
- ventricular arrhythmias;
- autonomic nervous system;
- continuous positive airway pressure
Obstructive sleep apnea (OSA) affects approximately 4% of middle-aged men and 2% of middle-aged women. Cardiac arrhythmias are common problems in patients with OSA, even though the true prevalence and clinical relevance of cardiac arrhythmias remains to be determined. The presence and complexity of both tachyarrhythmias and bradyarrhythmias may influence morbidity, mortality, and the quality of life for OSA patients. Although the exact mechanisms underlying the link between OSA and cardiac arrhythmias are not well established, they could be partially the same proposed mechanisms relating OSA to different cardiovascular diseases. OSA is characterized by repetitive pharyngeal collapse during sleep that leads to markedly reduced or absent airflow, followed by oxyhemoglobin desaturation, persistent inspiratory efforts against an occluded airway, and termination by arousal from sleep. These mechanisms elicit a variety of autonomic, hemodynamic, humoral, and neuroendocrine responses that by themselves evoke acute and chronic changes in cardiovascular function. These effects may lead to the development of cardiac arrhythmias and any other form of cardiovascular disease linked to OSA. The aims of this review are to describe the essential cardiovascular pathophysiological aspects of OSA, to outline the relationship between OSA and both tachyarrhythmias and bradyarrhythmias and their possible influence in the natural history of OSA patients, and to assess the effects of OSA treatment on the presence of cardiac arrhythmias.