Death and Cardiovascular Illness Associated with Sleep Apnoea

heartMore and more people suffer from death and debilitation associated with cardiovascular disease. This is why risk factors have to be identified and treated as soon as possible. Obstructive sleep apnoea is one such risk factor. This condition is characterised by repetitive episodes of complete or partial obstructions of the upper airway during sleep. It is said that if left untreated, sleep apnoea can cause significant cardiovascular morbidity and mortality, debilitating daytime symptoms and increased risk of work and motor vehicle accidents.

A recent meta-analysis from PLoS One in July 2013 aimed to quantitatively evaluate findings from prospective observational studies on OSA and future risk of cardiovascular and all-cause mortality, and determine whether OSA is an independent predictor of cardiovascular and all-cause mortality.

In this study, electronic literature databases (Medline and Embase) were searched for prospective observational studies published prior to December 2012. Only observational studies that assessed baseline OSA and future risk of cardiovascular and all-cause mortality were selected. Six studies with 11932 patients were identified and analysed, with 239 reporting cardiovascular mortality, and 1397 all-cause mortality. Pooled HR of all-cause mortality was 1.19 (95% CI, 1.00 to 1.41) for moderate OSA and 1.90 (95% CI, 1.29 to 2.81) for severe OSA. Pooled HR of cardiovascular mortality was 1.40 (95% CI, 0.77 to 2.53) for moderate OSA and 2.65 (95% CI, 1.82 to 3.85) for severe OSA. There were no differences in cardiovascular mortality in continuous positive airway pressure (CPAP) treatment compared with healthy subjects (HR 0.82; 95% CI, 0.50 to 1.33).

The study only showed that severe OSA is a strong independent predictor for future cardiovascular and all-cause mortality. Subjects with severe OSA increased 67% risk of all-cause mortality and 265% risk of cardiovascular mortality. In addition, CPAP treatment was associated with decreased cardiovascular mortality. Thus it is recommended that patients with sleep apnoea should be evaluated for cardiovascular risks.

So how should practitioners evaluate patients with sleep apnoea? A thorough medical history should be obtained. Blood tests such as lipid profile should also be obtained. An electrocardiogram should also be obtained and if there are some ischemic findings, echocardiography should be done.

This study concludes that severe OSA is a strong independent predictor for future cardiovascular and all-cause mortality. CPAP treatment was associated with decrease cardiovascular mortality. Thus all patients with sleep apnoea should be evaluated for cardiovascular risks.

Reference:

Ge X, Han F, Huang Y, Zhang Y, Yang T, Bai C, Guo X.Is obstructive sleep apnoea associated with cardiovascular and all-cause mortality? PLoS One. 2013 Jul 25;8(7):e69432.

Image  Courtesy of digitalart / freedigitalphotos.net

Somnowell Inventor - Visiting Professor Simon Ash FDS MSc MOrth BDS

Prof. Ash is the inventor of the highly successful SOMNOWELL Chrome device for snoring and sleep apnoea.

The Somnowell Chrome is made to exacting standards in the Somnowell laboratory under the supervision of Visiting Professor Simon Ash. Prof. Ash and his master technicians create each Somnowell Chrome device using their wealth of experience and expertise.

Prof. Ash works at the forefront of his profession. He is a Consultant and Specialist Orthodontist with over 30 years clinical experience, with a special interest in sleep related breathing disorders, TMJD, and bruxism. He currently works in Harley Street London and two private hospitals in London as part of a multi-disciplinary team managing snoring and sleep apnoea, and is Visiting Professor of Orthodontics at the BPP University.