Pathophysiologic Mechanisms of Cardiovascular Disease in Obstructive Sleep Apnea Syndrome

Obstructive sleep apnea syndrome (OSAS) is a highly prevalent sleep disorder, characterized by repeated disruptions of breathing during sleep. This disease has many potential consequences including excessive daytime sleepiness, neurocognitive deterioration, endocrinologic and metabolic effects, and...

Full description

Saved in:
Bibliographic Details
Main Authors: Carlos Zamarrón, Luis Valdés Cuadrado, Rodolfo Álvarez-Sala
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Pulmonary Medicine
Online Access:http://dx.doi.org/10.1155/2013/521087
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832552427968004096
author Carlos Zamarrón
Luis Valdés Cuadrado
Rodolfo Álvarez-Sala
author_facet Carlos Zamarrón
Luis Valdés Cuadrado
Rodolfo Álvarez-Sala
author_sort Carlos Zamarrón
collection DOAJ
description Obstructive sleep apnea syndrome (OSAS) is a highly prevalent sleep disorder, characterized by repeated disruptions of breathing during sleep. This disease has many potential consequences including excessive daytime sleepiness, neurocognitive deterioration, endocrinologic and metabolic effects, and decreased quality of life. Patients with OSAS experience repetitive episodes of hypoxia and reoxygenation during transient cessation of breathing that provoke systemic effects. Furthermore, there may be increased levels of biomarkers linked to endocrine-metabolic and cardiovascular alterations. Epidemiological studies have identified OSAS as an independent comorbid factor in cardiovascular and cerebrovascular diseases, and physiopathological links may exist with onset and progression of heart failure. In addition, OSAS is associated with other disorders and comorbidities which worsen cardiovascular consequences, such as obesity, diabetes, and metabolic syndrome. Metabolic syndrome is an emerging public health problem that represents a constellation of cardiovascular risk factors. Both OSAS and metabolic syndrome may exert negative synergistic effects on the cardiovascular system through multiple mechanisms (e.g., hypoxemia, sleep disruption, activation of the sympathetic nervous system, and inflammatory activation). It has been found that CPAP therapy for OSAS provides an objective improvement in symptoms and cardiac function, decreases cardiovascular risk, improves insulin sensitivity, and normalises biomarkers. OSAS contributes to the pathogenesis of cardiovascular disease independently and by interaction with comorbidities. The present review focuses on indirect and direct evidence regarding mechanisms implicated in cardiovascular disease among OSAS patients.
format Article
id doaj-art-4d2f54f5d71e44db9c5d4c26161a9ae8
institution Kabale University
issn 2090-1836
2090-1844
language English
publishDate 2013-01-01
publisher Wiley
record_format Article
series Pulmonary Medicine
spelling doaj-art-4d2f54f5d71e44db9c5d4c26161a9ae82025-02-03T05:58:40ZengWileyPulmonary Medicine2090-18362090-18442013-01-01201310.1155/2013/521087521087Pathophysiologic Mechanisms of Cardiovascular Disease in Obstructive Sleep Apnea SyndromeCarlos Zamarrón0Luis Valdés Cuadrado1Rodolfo Álvarez-Sala2Division of Respiratory, Hospital Clínico Universitario, c/Travesia de la Choupana s/n, A Coruña, 15706 Santiago, SpainDivision of Respiratory, Hospital Clínico Universitario, c/Travesia de la Choupana s/n, A Coruña, 15706 Santiago, SpainDivision of Respiratory, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, SpainObstructive sleep apnea syndrome (OSAS) is a highly prevalent sleep disorder, characterized by repeated disruptions of breathing during sleep. This disease has many potential consequences including excessive daytime sleepiness, neurocognitive deterioration, endocrinologic and metabolic effects, and decreased quality of life. Patients with OSAS experience repetitive episodes of hypoxia and reoxygenation during transient cessation of breathing that provoke systemic effects. Furthermore, there may be increased levels of biomarkers linked to endocrine-metabolic and cardiovascular alterations. Epidemiological studies have identified OSAS as an independent comorbid factor in cardiovascular and cerebrovascular diseases, and physiopathological links may exist with onset and progression of heart failure. In addition, OSAS is associated with other disorders and comorbidities which worsen cardiovascular consequences, such as obesity, diabetes, and metabolic syndrome. Metabolic syndrome is an emerging public health problem that represents a constellation of cardiovascular risk factors. Both OSAS and metabolic syndrome may exert negative synergistic effects on the cardiovascular system through multiple mechanisms (e.g., hypoxemia, sleep disruption, activation of the sympathetic nervous system, and inflammatory activation). It has been found that CPAP therapy for OSAS provides an objective improvement in symptoms and cardiac function, decreases cardiovascular risk, improves insulin sensitivity, and normalises biomarkers. OSAS contributes to the pathogenesis of cardiovascular disease independently and by interaction with comorbidities. The present review focuses on indirect and direct evidence regarding mechanisms implicated in cardiovascular disease among OSAS patients.http://dx.doi.org/10.1155/2013/521087
spellingShingle Carlos Zamarrón
Luis Valdés Cuadrado
Rodolfo Álvarez-Sala
Pathophysiologic Mechanisms of Cardiovascular Disease in Obstructive Sleep Apnea Syndrome
Pulmonary Medicine
title Pathophysiologic Mechanisms of Cardiovascular Disease in Obstructive Sleep Apnea Syndrome
title_full Pathophysiologic Mechanisms of Cardiovascular Disease in Obstructive Sleep Apnea Syndrome
title_fullStr Pathophysiologic Mechanisms of Cardiovascular Disease in Obstructive Sleep Apnea Syndrome
title_full_unstemmed Pathophysiologic Mechanisms of Cardiovascular Disease in Obstructive Sleep Apnea Syndrome
title_short Pathophysiologic Mechanisms of Cardiovascular Disease in Obstructive Sleep Apnea Syndrome
title_sort pathophysiologic mechanisms of cardiovascular disease in obstructive sleep apnea syndrome
url http://dx.doi.org/10.1155/2013/521087
work_keys_str_mv AT carloszamarron pathophysiologicmechanismsofcardiovasculardiseaseinobstructivesleepapneasyndrome
AT luisvaldescuadrado pathophysiologicmechanismsofcardiovasculardiseaseinobstructivesleepapneasyndrome
AT rodolfoalvarezsala pathophysiologicmechanismsofcardiovasculardiseaseinobstructivesleepapneasyndrome