Cardiovascular Complications of Obstructive Sleep Apnea in the Intensive Care Unit and Beyond

Abstract

Obstructive sleep apnea (OSA) is a common disease with a high degree of association with and possible etiological factor for several cardiovascular diseases. Patients who are admitted to the Intensive Care Unit (ICU) are incredibly sick, have multiple co-morbidities, and are at substantial risk for mortality. A study of cardiovascular manifestations and disease processes in patients with OSA admitted to the ICU is very intriguing, and its impact is likely significant. Although much is known about these cardiovascular complications associated with OSA, there is still a paucity of high-quality evidence trying to establish causality between the two. Studies exploring the potential impact of therapeutic interventions, such as positive airway pressure therapy (PAP), on cardiovascular complications in ICU patients are also needed and should be encouraged. This study reviewed the literature currently available on this topic and potential future research directions of this clinically significant relationship between OSA and cardiovascular disease processes in the ICU and beyond.

Keywords: CPAP; Intensive Care Units (ICU); arrythmia; atrial fibrillation; cardiovascular system; coronary artery disease; mortality; obesity; obstructive sleep apnea (OSA); outcomes; pulmonary hypertension (PH); sleep apnea; sleep apnea syndrome (SAS); stroke; treatment effective.

Figure 1

Novel risk factors linking OSA and cardiovascular disease [41,68,69,70,71,72,73,74]. (Modified and adapted from Ref. [68]) OSA: obstructive sleep apnea; AHI: apnea hypopnea index; CVD: Cardiovascular disease.