Impact of Obstructive Sleep Apnea on Cardiovascular Health: A Systematic Review.

Abstract

Obstructive sleep apnea (OSA) is characterized by recurrent interruptions in breathing during sleep and is associated with a wide range of significant health concerns, particularly cardiovascular complications. This review focuses on the two primary forms of sleep apnea, namely, obstructive and central, with OSA being the most prevalent and commonly linked to conditions, such as hypertension, arrhythmias, and heart failure. Intermittent hypoxemia, activation of the sympathetic nervous system, systemic inflammation, and remodeling of the ventricles are some of the pathophysiological mechanisms that link OSA to cardiovascular disease (CVD). These all lead to higher oxidative stress and endothelial dysfunction. These processes elevate the risk of CVDs, including hypertension, coronary artery disease, and stroke. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and examined studies published over the last 15 years. The search strategy utilized key terms such as "sleep disorder," "apnea," "hypertension," "cardiovascular disease (CVD)," and "treatment outcomes" across multiple databases, including PubMed, Scopus, Embase, and the Cochrane Library. A total of 128 unique studies were identified, of which 10 met the inclusion criteria and were included in the final analysis. These studies consistently highlighted the significant role OSA plays in exacerbating cardiovascular risks, particularly in patients with comorbid conditions such as obesity, hypertension, and diabetes.