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(Circulation. 2004;109:951-957.)
© 2004 American Heart Association, Inc.

Special Report

Cardiovascular Consequences of Sleep-Disordered Breathing: Past, Present and Future

Report of a Workshop From the National Center on Sleep Disorders Research and the National Heart, Lung, and Blood Institute

Stuart F. Quan, MD; Bernard J. Gersh, MBChB, DPhil

From Arizona Respiratory and Sleep Centers, University of Arizona College of Medicine, Tucson, Ariz (S.F.Q); and the Division of Cardiovascular Disease, Mayo Clinic and Mayo Foundation, Rochester, Minn (B.J.G.).

Correspondence Stuart F. Quan, MD, 1501 N Campbell Ave, Room 2305, Arizona Health Sciences Center, Tucson, AZ 85724. E-mail squan@resp-sci.arizona.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Sleep-disordered breathing (SDB), which includes obstructive sleep apnea (OSA) as its most extreme variant, is characterized by intermittent episodes of partial or complete obstruction of the upper airway during sleep that disrupts normal ventilation and sleep architecture and is typically associated with snoring and daytime sleepiness. SDB is common, with an incidence in middle-aged men and women of 4% and 2%, respectively.¹ Major risk factors for SDB include obesity, male gender, increasing age, and abnormalities of craniofacial morphology.²

There is an increasing perception that SDB/OSA via various mechanisms increases cardiovascular morbidity and mortality (Figure 1). However, many risk factors for SDB/OSA, such as obesity and male gender, are the same as for hypertension and cardiovascular disease.³ Thus, only recently has there been converging evidence that SDB is a risk factor for their development.^4–6 Moreover, there is increasing information to indicate that SDB/OSA is linked to metabolic, vascular, hematologic, and genetic markers associated with increased cardiovascular disease risk. In addition, central sleep apnea (CSA), another form of SDB, appears to be an important factor that influences morbidity and mortality among those with heart failure (HF). Nevertheless, responsible mechanisms, the role of SDB as a risk factor "independent" of associated comorbidities, and whether treatment of SDB will mitigate this risk are unknown and remain to be determined.

View larger version (45K): [in this window] [in a new window]   Figure 1. This illustrates the range of cardiovascular diseases and potential mechanisms that may be associated with sleep-disordered breathing. As illustrated in this figure, there is likely an interaction between multiple potential mechanisms, . . . [Full Text of this Article]

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