Skip to main content
Top
Published in: Journal of Cardiovascular Translational Research 1/2011

01-02-2011

Cardiovascular Implications in the Treatment of Obstructive Sleep Apnea

Authors: Olivier M. Vanderveken, An Boudewyns, Quan Ni, Bhavani Kashyap, Johan Verbraecken, Wilfried De Backer, Paul Van de Heyning

Published in: Journal of Cardiovascular Translational Research | Issue 1/2011

Login to get access

Abstract

Epidemiological studies provide strong evidence that obstructive sleep apnea (OSA) is associated with cardiovascular complications such as systemic hypertension, congestive heart failure, and atrial fibrillation. Successful OSA treatment with continuous positive airway pressure (CPAP) has resulted in coincident reductions in systemic hypertension, improvements in left ventricular systolic function, and reductions in sympathetic nervous activity. These data suggest that successful treatment of OSA may reduce cardiovascular morbidity in such patients. Although CPAP is the more successful treatment for OSA when used properly and consistently, its clinical success is often limited by poor patient and partner acceptance, which leads to suboptimal compliance. Oral appliances or upper airway surgeries are considered a second line of treatment for patients with mild to moderate OSA who do not comply with or refuse long-term CPAP treatment. Oral devices such as mandibular repositioning appliances were recently shown to improve arterial hypertension in OSA patients. Electrical stimulation of the hypoglossal nerve is a new investigational therapy for patients with moderate to severe OSA. This new treatment option, if proven effective, may provide cardiovascular benefits secondary to treating OSA.
Literature
1.
go back to reference American Academy of Sleep Medicine Task Force (1999). Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The report of an American Academy of Sleep Medicine Task Force. Sleep, 22, 667–689. American Academy of Sleep Medicine Task Force (1999). Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The report of an American Academy of Sleep Medicine Task Force. Sleep, 22, 667–689.
2.
go back to reference Young, T., Palta, M., Dempsey, J., et al. (1993). The occurrence of sleep-disordered breathing among middle-aged adults. The New England Journal of Medicine, 328, 1230–1235.CrossRefPubMed Young, T., Palta, M., Dempsey, J., et al. (1993). The occurrence of sleep-disordered breathing among middle-aged adults. The New England Journal of Medicine, 328, 1230–1235.CrossRefPubMed
3.
go back to reference Bradley, T. D., & Floras, J. S. (2003). Sleep apnea and heart failure: Part I: obstructive sleep apnea. Circulation, 107, 1671–1678.CrossRefPubMed Bradley, T. D., & Floras, J. S. (2003). Sleep apnea and heart failure: Part I: obstructive sleep apnea. Circulation, 107, 1671–1678.CrossRefPubMed
4.
go back to reference Bradley, T. D., & Floras, J. S. (2009). Obstructive sleep apnoea and its cardiovascular consequences. Lancet, 373, 82–93.CrossRefPubMed Bradley, T. D., & Floras, J. S. (2009). Obstructive sleep apnoea and its cardiovascular consequences. Lancet, 373, 82–93.CrossRefPubMed
5.
go back to reference Somers, V. K., White, D. P., Amin, R., et al. (2008). Sleep apnea and cardiovascular disease: an American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council On Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing in collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation, 118, 1080–1111.CrossRefPubMed Somers, V. K., White, D. P., Amin, R., et al. (2008). Sleep apnea and cardiovascular disease: an American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council On Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing in collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation, 118, 1080–1111.CrossRefPubMed
6.
go back to reference Stoohs, R., & Guilleminault, C. (1992). Cardiovascular changes associated with obstructive sleep apnea syndrome. Journal of Applied Physiology, 72, 583–589.PubMed Stoohs, R., & Guilleminault, C. (1992). Cardiovascular changes associated with obstructive sleep apnea syndrome. Journal of Applied Physiology, 72, 583–589.PubMed
7.
go back to reference Dyugovskaya, L., Lavie, P., & Lavie, L. (2002). Increased adhesion molecules expression and production of reactive oxygen species in leukocytes of sleep apnea patients. American Journal of Respiratory and Critical Care Medicine, 165, 934–939.PubMed Dyugovskaya, L., Lavie, P., & Lavie, L. (2002). Increased adhesion molecules expression and production of reactive oxygen species in leukocytes of sleep apnea patients. American Journal of Respiratory and Critical Care Medicine, 165, 934–939.PubMed
8.
go back to reference Ryan, S., Taylor, C. T., & McNicholas, W. T. (2005). Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation, 112, 2660–2667.CrossRefPubMed Ryan, S., Taylor, C. T., & McNicholas, W. T. (2005). Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation, 112, 2660–2667.CrossRefPubMed
9.
go back to reference Brooks, D., Horner, R. L., Kozar, L. F., et al. (1997). Obstructive sleep apnea as a cause of systemic hypertension. Evidence from a canine model. Journal of Clinical Investigation, 99, 106–109.CrossRefPubMed Brooks, D., Horner, R. L., Kozar, L. F., et al. (1997). Obstructive sleep apnea as a cause of systemic hypertension. Evidence from a canine model. Journal of Clinical Investigation, 99, 106–109.CrossRefPubMed
10.
go back to reference Narkiewicz, K., Montano, N., Cogliati, C., et al. (1998). Altered cardiovascular variability in obstructive sleep apnea. Circulation, 98, 1071–1077.PubMed Narkiewicz, K., Montano, N., Cogliati, C., et al. (1998). Altered cardiovascular variability in obstructive sleep apnea. Circulation, 98, 1071–1077.PubMed
11.
go back to reference Chan, A. S., & Cistulli, P. A. (2009). Oral appliance treatment of obstructive sleep apnea: an update. Current Opinion in Pulmonary Medicine, 15, 591–596.CrossRef Chan, A. S., & Cistulli, P. A. (2009). Oral appliance treatment of obstructive sleep apnea: an update. Current Opinion in Pulmonary Medicine, 15, 591–596.CrossRef
12.
go back to reference Randerath, W. J., Heise, M., Hinz, R., et al. (2002). An individually adjustable oral appliance vs continuous positive airway pressure in mild-to-moderate obstructive sleep apnea syndrome. Chest, 122, 569–575.CrossRefPubMed Randerath, W. J., Heise, M., Hinz, R., et al. (2002). An individually adjustable oral appliance vs continuous positive airway pressure in mild-to-moderate obstructive sleep apnea syndrome. Chest, 122, 569–575.CrossRefPubMed
13.
go back to reference Marin, J. M., Carrizo, S. J., Vicente, E., et al. (2005). Long-term cardiovascular outcomes in men with obstructive sleep apnoea–hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet, 365, 1046–1053.PubMed Marin, J. M., Carrizo, S. J., Vicente, E., et al. (2005). Long-term cardiovascular outcomes in men with obstructive sleep apnoea–hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet, 365, 1046–1053.PubMed
14.
go back to reference Selim, B., Won, C., & Yaggi, H. K. (2010). Cardiovascular consequences of sleep apnea. Clinics in Chest Medicine, 31, 203–220.CrossRefPubMed Selim, B., Won, C., & Yaggi, H. K. (2010). Cardiovascular consequences of sleep apnea. Clinics in Chest Medicine, 31, 203–220.CrossRefPubMed
15.
go back to reference Chobanian, A. V., Bakris, G. L., Black, H. R., et al. (2003). Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension, 42, 1206–1252.CrossRefPubMed Chobanian, A. V., Bakris, G. L., Black, H. R., et al. (2003). Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension, 42, 1206–1252.CrossRefPubMed
16.
go back to reference Bixler, E. O., Vgontzas, A. N., Lin, H. M., et al. (2000). Association of hypertension and sleep-disordered breathing. Archives of Internal Medicine, 160, 2289–2295.CrossRefPubMed Bixler, E. O., Vgontzas, A. N., Lin, H. M., et al. (2000). Association of hypertension and sleep-disordered breathing. Archives of Internal Medicine, 160, 2289–2295.CrossRefPubMed
17.
go back to reference Peppard, P. E., Young, T., Palta, M., et al. (2000). Prospective study of the association between sleep-disordered breathing and hypertension. The New England Journal of Medicine, 342, 1378–1384.CrossRefPubMed Peppard, P. E., Young, T., Palta, M., et al. (2000). Prospective study of the association between sleep-disordered breathing and hypertension. The New England Journal of Medicine, 342, 1378–1384.CrossRefPubMed
18.
go back to reference Nieto, F. J., Young, T. B., Lind, B. K., et al. (2000). Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. Jama, 283, 1829–1836.CrossRefPubMed Nieto, F. J., Young, T. B., Lind, B. K., et al. (2000). Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. Jama, 283, 1829–1836.CrossRefPubMed
19.
go back to reference O’Connor, G. T., Caffo, B., Newman, A. B., et al. (2009). Prospective study of sleep-disordered breathing and hypertension: the sleep heart health study. American Journal of Respiratory and Critical Care Medicine, 179, 1159–1164.CrossRefPubMed O’Connor, G. T., Caffo, B., Newman, A. B., et al. (2009). Prospective study of sleep-disordered breathing and hypertension: the sleep heart health study. American Journal of Respiratory and Critical Care Medicine, 179, 1159–1164.CrossRefPubMed
20.
go back to reference Lloyd-Jones, D. M., Larson, M. G., Leip, E. P., et al. (2002). Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation, 106, 3068–3072.CrossRefPubMed Lloyd-Jones, D. M., Larson, M. G., Leip, E. P., et al. (2002). Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation, 106, 3068–3072.CrossRefPubMed
21.
go back to reference Shahar, E., Whitney, C. W., Redline, S., et al. (2001). Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the sleep heart health study. American Journal of Respiratory and Critical Care Medicine, 163, 19–25.PubMed Shahar, E., Whitney, C. W., Redline, S., et al. (2001). Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the sleep heart health study. American Journal of Respiratory and Critical Care Medicine, 163, 19–25.PubMed
22.
go back to reference Mehra, R., Benjamin, E. J., Shahar, E., et al. (2006). Association of nocturnal arrhythmias with sleep-disordered breathing: the Sleep Heart Health Study. American Journal of Respiratory and Critical Care Medicine, 173, 910–916.CrossRefPubMed Mehra, R., Benjamin, E. J., Shahar, E., et al. (2006). Association of nocturnal arrhythmias with sleep-disordered breathing: the Sleep Heart Health Study. American Journal of Respiratory and Critical Care Medicine, 173, 910–916.CrossRefPubMed
23.
go back to reference Wang, H., Parker, J. D., Newton, G. E., et al. (2007). Influence of obstructive sleep apnea on mortality in patients with heart failure. Journal of the American College of Cardiology, 49, 1625–1631.CrossRefPubMed Wang, H., Parker, J. D., Newton, G. E., et al. (2007). Influence of obstructive sleep apnea on mortality in patients with heart failure. Journal of the American College of Cardiology, 49, 1625–1631.CrossRefPubMed
24.
go back to reference Sin, D. D., Fitzgerald, F., Parker, J. D., et al. (1999). Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure. American Journal of Respiratory and Critical Care Medicine, 160, 1101–1106.PubMed Sin, D. D., Fitzgerald, F., Parker, J. D., et al. (1999). Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure. American Journal of Respiratory and Critical Care Medicine, 160, 1101–1106.PubMed
25.
go back to reference Lloyd-Jones, D. M., Wilson, P. W., Larson, M. G., et al. (2004). Framingham risk score and prediction of lifetime risk for coronary heart disease. The American Journal of Cardiology, 94, 20–24.CrossRefPubMed Lloyd-Jones, D. M., Wilson, P. W., Larson, M. G., et al. (2004). Framingham risk score and prediction of lifetime risk for coronary heart disease. The American Journal of Cardiology, 94, 20–24.CrossRefPubMed
26.
go back to reference Somers, V. K., Dyken, M. E., Clary, M. P., et al. (1995). Sympathetic neural mechanisms in obstructive sleep apnea. Journal of Clinical Investigation, 96, 1897–1904.CrossRefPubMed Somers, V. K., Dyken, M. E., Clary, M. P., et al. (1995). Sympathetic neural mechanisms in obstructive sleep apnea. Journal of Clinical Investigation, 96, 1897–1904.CrossRefPubMed
27.
go back to reference Chou, C. C., & Chen, P. S. (2008). New concepts in atrial fibrillation: mechanism and remodeling. The Medical Clinics of North America, 92, 53–63.CrossRefPubMed Chou, C. C., & Chen, P. S. (2008). New concepts in atrial fibrillation: mechanism and remodeling. The Medical Clinics of North America, 92, 53–63.CrossRefPubMed
28.
go back to reference Condos, W. R., Jr., Latham, R. D., Hoadley, S. D., et al. (1987). Hemodynamics of the mueller maneuver in man: right and left heart micromanometry and doppler echocardiography. Circulation, 76, 1020–1028.PubMed Condos, W. R., Jr., Latham, R. D., Hoadley, S. D., et al. (1987). Hemodynamics of the mueller maneuver in man: right and left heart micromanometry and doppler echocardiography. Circulation, 76, 1020–1028.PubMed
29.
go back to reference Hall, M. J., Ando, S., Floras, J. S., et al. (1998). Magnitude and time course of hemodynamic responses to Mueller maneuvers in patients with congestive heart failure. Journal of Applied Physiology, 85, 1476–1484.PubMed Hall, M. J., Ando, S., Floras, J. S., et al. (1998). Magnitude and time course of hemodynamic responses to Mueller maneuvers in patients with congestive heart failure. Journal of Applied Physiology, 85, 1476–1484.PubMed
30.
go back to reference Drager, L. F., Bortolotto, L. A., Pedrosa, R. P., et al. (2010). Left atrial diameter is independently associated with arterial stiffness in patients with obstructive sleep apnea: potential implications for atrial fibrillation. International Journal of Cardiology, 144(2), 257–259.CrossRefPubMed Drager, L. F., Bortolotto, L. A., Pedrosa, R. P., et al. (2010). Left atrial diameter is independently associated with arterial stiffness in patients with obstructive sleep apnea: potential implications for atrial fibrillation. International Journal of Cardiology, 144(2), 257–259.CrossRefPubMed
31.
go back to reference Franz, M. R., & Bode, F. (2003). Mechano-electrical feedback underlying arrhythmias: the atrial fibrillation case. Progress in Biophysics and Molecular Biology, 82, 163–174.CrossRefPubMed Franz, M. R., & Bode, F. (2003). Mechano-electrical feedback underlying arrhythmias: the atrial fibrillation case. Progress in Biophysics and Molecular Biology, 82, 163–174.CrossRefPubMed
32.
go back to reference Shamsuzzaman, A. S., Winnicki, M., Lanfranchi, P., et al. (2002). Elevated C-reactive protein in patients with obstructive sleep apnea. Circulation, 105, 2462–2464.CrossRefPubMed Shamsuzzaman, A. S., Winnicki, M., Lanfranchi, P., et al. (2002). Elevated C-reactive protein in patients with obstructive sleep apnea. Circulation, 105, 2462–2464.CrossRefPubMed
33.
go back to reference Chung, M. K., Martin, D. O., Sprecher, D., et al. (2001). C-reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation. Circulation, 104, 2886–2891.CrossRefPubMed Chung, M. K., Martin, D. O., Sprecher, D., et al. (2001). C-reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation. Circulation, 104, 2886–2891.CrossRefPubMed
34.
go back to reference Guilleminault, C., Connolly, S. J., & Winkle, R. A. (1983). Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome. The American Journal of Cardiology, 52, 490–494.CrossRefPubMed Guilleminault, C., Connolly, S. J., & Winkle, R. A. (1983). Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome. The American Journal of Cardiology, 52, 490–494.CrossRefPubMed
35.
go back to reference Gami, A. S., Pressman, G., Caples, S. M., et al. (2004). Association of atrial fibrillation and obstructive sleep apnea. Circulation, 110, 364–367.CrossRefPubMed Gami, A. S., Pressman, G., Caples, S. M., et al. (2004). Association of atrial fibrillation and obstructive sleep apnea. Circulation, 110, 364–367.CrossRefPubMed
36.
go back to reference Gami, A. S., Hodge, D. O., Herges, R. M., et al. (2007). Obstructive sleep apnea, obesity, and the risk of incident atrial fibrillation. Journal of the American College of Cardiology, 49, 565–571.CrossRefPubMed Gami, A. S., Hodge, D. O., Herges, R. M., et al. (2007). Obstructive sleep apnea, obesity, and the risk of incident atrial fibrillation. Journal of the American College of Cardiology, 49, 565–571.CrossRefPubMed
37.
go back to reference Sullivan, C., Issa, F., Berthon-Jones, M., et al. (1981). Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet, 1, 862.CrossRefPubMed Sullivan, C., Issa, F., Berthon-Jones, M., et al. (1981). Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet, 1, 862.CrossRefPubMed
38.
go back to reference Ballester, E., Badia, J. R., Hernandez, L., et al. (1999). Evidence of the effectiveness of continuous positive airway pressure in the treatment of sleep apnea/hypopnea syndrome. American Journal of Respiratory and Critical Care Medicine, 159, 495–501.PubMed Ballester, E., Badia, J. R., Hernandez, L., et al. (1999). Evidence of the effectiveness of continuous positive airway pressure in the treatment of sleep apnea/hypopnea syndrome. American Journal of Respiratory and Critical Care Medicine, 159, 495–501.PubMed
39.
go back to reference Giles, T. L., Lasserson, T. J., Smith, B. H., et al. (2006). Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database of Systematic Reviews, 3, CD001106. Giles, T. L., Lasserson, T. J., Smith, B. H., et al. (2006). Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database of Systematic Reviews, 3, CD001106.
40.
go back to reference Gordon, P., & Sanders, M. H. (2005). Sleep. 7: positive airway pressure therapy for obstructive sleep apnoea/hypopnoea syndrome. Thorax, 60, 68–75.CrossRefPubMed Gordon, P., & Sanders, M. H. (2005). Sleep. 7: positive airway pressure therapy for obstructive sleep apnoea/hypopnoea syndrome. Thorax, 60, 68–75.CrossRefPubMed
41.
go back to reference Montserrat, J. M., Ferrer, M., Hernandez, L., et al. (2001). Effectiveness of CPAP treatment in daytime function in sleep apnea syndrome: a randomized controlled study with an optimized placebo. American Journal of Respiratory and Critical Care Medicine, 164, 608–613.PubMed Montserrat, J. M., Ferrer, M., Hernandez, L., et al. (2001). Effectiveness of CPAP treatment in daytime function in sleep apnea syndrome: a randomized controlled study with an optimized placebo. American Journal of Respiratory and Critical Care Medicine, 164, 608–613.PubMed
42.
go back to reference Amfilochiou, A., Tsara, V., Kolilekas, L., et al. (2009). Determinants of continuous positive airway pressure compliance in a group of Greek patients with obstructive sleep apnea. European Journal of Internal Medicine, 20, 645–650.CrossRefPubMed Amfilochiou, A., Tsara, V., Kolilekas, L., et al. (2009). Determinants of continuous positive airway pressure compliance in a group of Greek patients with obstructive sleep apnea. European Journal of Internal Medicine, 20, 645–650.CrossRefPubMed
43.
go back to reference De Backer, W. (1998). Non-CPAP treatment of obstructive sleep apnoea. Monaldi Archives for Chest Disease, 53, 625–629.PubMed De Backer, W. (1998). Non-CPAP treatment of obstructive sleep apnoea. Monaldi Archives for Chest Disease, 53, 625–629.PubMed
44.
go back to reference Grote, L., Hedner, J., Grunstein, R., et al. (2000). Therapy with nCPAP: incomplete elimination of sleep related breathing disorder. The European Respiratory Journal, 16, 921–927.CrossRefPubMed Grote, L., Hedner, J., Grunstein, R., et al. (2000). Therapy with nCPAP: incomplete elimination of sleep related breathing disorder. The European Respiratory Journal, 16, 921–927.CrossRefPubMed
45.
go back to reference Lindberg, E., Berne, C., Elmasry, A., et al. (2006). CPAP treatment of a population-based sample—what are the benefits and the treatment compliance? Sleep Medicine, 7, 553.CrossRefPubMed Lindberg, E., Berne, C., Elmasry, A., et al. (2006). CPAP treatment of a population-based sample—what are the benefits and the treatment compliance? Sleep Medicine, 7, 553.CrossRefPubMed
46.
go back to reference Duran-Cantolla, J., Aizpuru, F., Martinez-Null, C., et al. (2009). Obstructive sleep apnea/hypopnea and systemic hypertension. Sleep Medicine Reviews, 13, 323–331.CrossRefPubMed Duran-Cantolla, J., Aizpuru, F., Martinez-Null, C., et al. (2009). Obstructive sleep apnea/hypopnea and systemic hypertension. Sleep Medicine Reviews, 13, 323–331.CrossRefPubMed
47.
go back to reference McNicholas, W. T. (2007). Cardiovascular outcomes of CPAP therapy in obstructive sleep apnea syndrome. American Journal of Physiology: Regulatory, Integrative and Comparative Physiology, 293, R1666–R1670.PubMed McNicholas, W. T. (2007). Cardiovascular outcomes of CPAP therapy in obstructive sleep apnea syndrome. American Journal of Physiology: Regulatory, Integrative and Comparative Physiology, 293, R1666–R1670.PubMed
48.
go back to reference Bazzano, L. A., Khan, Z., Reynolds, K., et al. (2007). Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension, 50, 417–423.CrossRefPubMed Bazzano, L. A., Khan, Z., Reynolds, K., et al. (2007). Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension, 50, 417–423.CrossRefPubMed
49.
go back to reference Haentjens, P., Van Meerhaeghe, A., Moscariello, A., et al. (2007). The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo-controlled randomized trials. Archives of Internal Medicine, 167, 757–764.CrossRefPubMed Haentjens, P., Van Meerhaeghe, A., Moscariello, A., et al. (2007). The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo-controlled randomized trials. Archives of Internal Medicine, 167, 757–764.CrossRefPubMed
50.
go back to reference Mayer, J., Becker, H., Brandenburg, U., et al. (1991). Blood pressure and sleep apnea: results of long-term nasal continuous positive airway pressure therapy. Cardiology, 79, 84–92.CrossRefPubMed Mayer, J., Becker, H., Brandenburg, U., et al. (1991). Blood pressure and sleep apnea: results of long-term nasal continuous positive airway pressure therapy. Cardiology, 79, 84–92.CrossRefPubMed
51.
go back to reference Sanner, B. M., Tepel, M., Markmann, A., et al. (2002). Effect of continuous positive airway pressure therapy on 24-hour blood pressure in patients with obstructive sleep apnea syndrome. American Journal of Hypertension, 15, 251–257.CrossRefPubMed Sanner, B. M., Tepel, M., Markmann, A., et al. (2002). Effect of continuous positive airway pressure therapy on 24-hour blood pressure in patients with obstructive sleep apnea syndrome. American Journal of Hypertension, 15, 251–257.CrossRefPubMed
52.
go back to reference Shivalkar, B., Van de Heyning, C., Kerremans, M., et al. (2006). Obstructive sleep apnea syndrome: more insights on structural and functional cardiac alterations, and the effects of treatment with continuous positive airway pressure. Journal of the American College of Cardiology, 47, 1433–1439.CrossRefPubMed Shivalkar, B., Van de Heyning, C., Kerremans, M., et al. (2006). Obstructive sleep apnea syndrome: more insights on structural and functional cardiac alterations, and the effects of treatment with continuous positive airway pressure. Journal of the American College of Cardiology, 47, 1433–1439.CrossRefPubMed
53.
go back to reference Martinez-Garcia, M. A., Gomez-Aldaravi, R., Soler-Cataluna, J. J., et al. (2007). Positive effect of CPAP treatment on the control of difficult-to-treat hypertension. The European Respiratory Journal, 29, 951–957.CrossRefPubMed Martinez-Garcia, M. A., Gomez-Aldaravi, R., Soler-Cataluna, J. J., et al. (2007). Positive effect of CPAP treatment on the control of difficult-to-treat hypertension. The European Respiratory Journal, 29, 951–957.CrossRefPubMed
54.
go back to reference Brotman, D. J., Davidson, M. B., Boumitri, M., et al. (2008). Impaired diurnal blood pressure variation and all-cause mortality. American Journal of Hypertension, 21, 92–97.CrossRefPubMed Brotman, D. J., Davidson, M. B., Boumitri, M., et al. (2008). Impaired diurnal blood pressure variation and all-cause mortality. American Journal of Hypertension, 21, 92–97.CrossRefPubMed
55.
go back to reference Barbe, F., Duran-Cantolla, J., Capote, F., et al. (2010). Long-term effect of continuous positive airway pressure in hypertensive patients with sleep apnea. American Journal of Respiratory and Critical Care Medicine, 181, 718–726.CrossRefPubMed Barbe, F., Duran-Cantolla, J., Capote, F., et al. (2010). Long-term effect of continuous positive airway pressure in hypertensive patients with sleep apnea. American Journal of Respiratory and Critical Care Medicine, 181, 718–726.CrossRefPubMed
56.
go back to reference Kaneko, Y., Floras, J. S., Usui, K., et al. (2003). Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea. The New England Journal of Medicine, 348, 1233–1241.CrossRefPubMed Kaneko, Y., Floras, J. S., Usui, K., et al. (2003). Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea. The New England Journal of Medicine, 348, 1233–1241.CrossRefPubMed
57.
go back to reference Mansfield, D. R., & Naughton, M. T. (2004). Sleep apnea and congestive heart failure. Minerva Medica, 95, 257–280.PubMed Mansfield, D. R., & Naughton, M. T. (2004). Sleep apnea and congestive heart failure. Minerva Medica, 95, 257–280.PubMed
58.
go back to reference Kanagala, R., Murali, N. S., Friedman, P. A., et al. (2003). Obstructive sleep apnea and the recurrence of atrial fibrillation. Circulation, 107, 2589–2594.PubMed Kanagala, R., Murali, N. S., Friedman, P. A., et al. (2003). Obstructive sleep apnea and the recurrence of atrial fibrillation. Circulation, 107, 2589–2594.PubMed
59.
go back to reference Lavie, P., Lavie, L., & Herer, P. (2005). All-cause mortality in males with sleep apnoea syndrome: declining mortality rates with age. The European Respiratory Journal, 25, 514–520.CrossRefPubMed Lavie, P., Lavie, L., & Herer, P. (2005). All-cause mortality in males with sleep apnoea syndrome: declining mortality rates with age. The European Respiratory Journal, 25, 514–520.CrossRefPubMed
60.
go back to reference Yaggi, H. K., Concato, J., Kernan, W. N., et al. (2005). Obstructive sleep apnea as a risk factor for stroke and death. The New England Journal of Medicine, 353, 2034–2041.CrossRefPubMed Yaggi, H. K., Concato, J., Kernan, W. N., et al. (2005). Obstructive sleep apnea as a risk factor for stroke and death. The New England Journal of Medicine, 353, 2034–2041.CrossRefPubMed
61.
go back to reference Young, T., Finn, L., Peppard, P. E., et al. (2008). Sleep disordered breathing and mortality: eighteen-year follow-up of the wisconsin sleep cohort. Sleep, 31, 1071–1078.PubMed Young, T., Finn, L., Peppard, P. E., et al. (2008). Sleep disordered breathing and mortality: eighteen-year follow-up of the wisconsin sleep cohort. Sleep, 31, 1071–1078.PubMed
62.
go back to reference Marshall, N. S., Wong, K. K., Liu, P. Y., et al. (2008). Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study. Sleep, 31, 1079–1085.PubMed Marshall, N. S., Wong, K. K., Liu, P. Y., et al. (2008). Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study. Sleep, 31, 1079–1085.PubMed
63.
go back to reference Chan, A. S., & Cistulli, P. A. (2009). Oral appliance treatment of obstructive sleep apnea: an update. Current Opinion in Pulmonary Medicine. (in press). Chan, A. S., & Cistulli, P. A. (2009). Oral appliance treatment of obstructive sleep apnea: an update. Current Opinion in Pulmonary Medicine. (in press).
64.
go back to reference McArdle, N., Devereux, G., Heidarnejad, H., et al. (1999). Long-term use of cpap therapy for sleep apnea/hypopnea syndrome. American Journal of Respiratory and Critical Care Medicine, 159, 1108–1114.PubMed McArdle, N., Devereux, G., Heidarnejad, H., et al. (1999). Long-term use of cpap therapy for sleep apnea/hypopnea syndrome. American Journal of Respiratory and Critical Care Medicine, 159, 1108–1114.PubMed
65.
go back to reference Weaver, T. E., Kribbs, N. B., Pack, A. I., et al. (1997). Night-to-night variability in cpap use over the first 3 months of treatment. Sleep, 20, 278–283.PubMed Weaver, T. E., Kribbs, N. B., Pack, A. I., et al. (1997). Night-to-night variability in cpap use over the first 3 months of treatment. Sleep, 20, 278–283.PubMed
66.
go back to reference Vanderveken, O. M., Devolder, A., Marklund, M., et al. (2008). Comparison of a custom-made and a thermoplastic oral appliance for the treatment of mild sleep apnea. American Journal of Respiratory and Critical Care Medicine, 178, 197–202.CrossRefPubMed Vanderveken, O. M., Devolder, A., Marklund, M., et al. (2008). Comparison of a custom-made and a thermoplastic oral appliance for the treatment of mild sleep apnea. American Journal of Respiratory and Critical Care Medicine, 178, 197–202.CrossRefPubMed
67.
go back to reference Ferguson, K. A., Cartwright, R., Rogers, R., et al. (2006). Oral appliances for snoring and obstructive sleep apnea: a review. Sleep, 29, 244–262.PubMed Ferguson, K. A., Cartwright, R., Rogers, R., et al. (2006). Oral appliances for snoring and obstructive sleep apnea: a review. Sleep, 29, 244–262.PubMed
68.
go back to reference Kushida, C. A., Morgenthaler, T. I., Littner, M. R., et al. (2006). Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances: an update for 2005. Sleep, 29, 240–243.PubMed Kushida, C. A., Morgenthaler, T. I., Littner, M. R., et al. (2006). Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances: an update for 2005. Sleep, 29, 240–243.PubMed
69.
go back to reference Cistulli, P. A., Gotsopoulos, H., Marklund, M., et al. (2004). Treatment of snoring and obstructive sleep apnea with mandibular repositioning appliances. Sleep Medicine Reviews, 8, 443–457.PubMed Cistulli, P. A., Gotsopoulos, H., Marklund, M., et al. (2004). Treatment of snoring and obstructive sleep apnea with mandibular repositioning appliances. Sleep Medicine Reviews, 8, 443–457.PubMed
70.
go back to reference Gotsopoulos, H., Kelly, J. J., & Cistulli, P. A. (2004). Oral appliance therapy reduces blood pressure in obstructive sleep apnea: a randomized, controlled trial. Sleep, 27, 934–941.PubMed Gotsopoulos, H., Kelly, J. J., & Cistulli, P. A. (2004). Oral appliance therapy reduces blood pressure in obstructive sleep apnea: a randomized, controlled trial. Sleep, 27, 934–941.PubMed
71.
go back to reference Andren, A., Sjoquist, M., & Tegelberg, A. (2009). Effects on blood pressure after treatment of obstructive sleep apnoea with a mandibular advancement appliance—a 3-year follow-up. Journal of Oral Rehabilitation, 36, 719–725.CrossRefPubMed Andren, A., Sjoquist, M., & Tegelberg, A. (2009). Effects on blood pressure after treatment of obstructive sleep apnoea with a mandibular advancement appliance—a 3-year follow-up. Journal of Oral Rehabilitation, 36, 719–725.CrossRefPubMed
72.
go back to reference Otsuka, R., Ribeiro de Almeida, F., Lowe, A. A., et al. (2006). The effect of oral appliance therapy on blood pressure in patients with obstructive sleep apnea. Sleep & Breathing, 10, 29–36.CrossRef Otsuka, R., Ribeiro de Almeida, F., Lowe, A. A., et al. (2006). The effect of oral appliance therapy on blood pressure in patients with obstructive sleep apnea. Sleep & Breathing, 10, 29–36.CrossRef
73.
go back to reference Barnes, M., McEvoy, R. D., Banks, S., et al. (2004). Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea. American Journal of Respiratory and Critical Care Medicine, 170, 656–664.CrossRefPubMed Barnes, M., McEvoy, R. D., Banks, S., et al. (2004). Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea. American Journal of Respiratory and Critical Care Medicine, 170, 656–664.CrossRefPubMed
74.
go back to reference Yoshida, K. (2006). Effect on blood pressure of oral appliance therapy for sleep apnea syndrome. The International Journal of Prosthodontics, 19, 61–66.PubMed Yoshida, K. (2006). Effect on blood pressure of oral appliance therapy for sleep apnea syndrome. The International Journal of Prosthodontics, 19, 61–66.PubMed
75.
go back to reference Coruzzi, P., Gualerzi, M., Bernkopf, E., et al. (2006). Autonomic cardiac modulation in obstructive sleep apnea: effect of an oral jaw-positioning appliance. Chest, 130, 1362–1368.CrossRefPubMed Coruzzi, P., Gualerzi, M., Bernkopf, E., et al. (2006). Autonomic cardiac modulation in obstructive sleep apnea: effect of an oral jaw-positioning appliance. Chest, 130, 1362–1368.CrossRefPubMed
76.
go back to reference Kribbs, N. B., Pack, A. I., Kline, L. R., et al. (1993). Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. The American Review of Respiratory Disease, 147, 887–895.PubMed Kribbs, N. B., Pack, A. I., Kline, L. R., et al. (1993). Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. The American Review of Respiratory Disease, 147, 887–895.PubMed
77.
go back to reference Krieger, J., & Kurtz, D. (1988). Objective measurement of compliance with nasal CPAP treatment for obstructive sleep apnoea syndrome. The European Respiratory Journal, 1, 436–438.PubMed Krieger, J., & Kurtz, D. (1988). Objective measurement of compliance with nasal CPAP treatment for obstructive sleep apnoea syndrome. The European Respiratory Journal, 1, 436–438.PubMed
78.
go back to reference Rauscher, H., Formanek, D., Popp, W., et al. (1993). Self-reported vs measured compliance with nasal CPAP for obstructive sleep apnea. Chest, 103, 1675–1680.CrossRefPubMed Rauscher, H., Formanek, D., Popp, W., et al. (1993). Self-reported vs measured compliance with nasal CPAP for obstructive sleep apnea. Chest, 103, 1675–1680.CrossRefPubMed
79.
go back to reference Gagnadoux, F., Fleury, B., Vielle, B., et al. (2009). Titrated mandibular advancement versus positive airway pressure for sleep apnoea. The European Respiratory Journal, 34, 914–920.CrossRefPubMed Gagnadoux, F., Fleury, B., Vielle, B., et al. (2009). Titrated mandibular advancement versus positive airway pressure for sleep apnoea. The European Respiratory Journal, 34, 914–920.CrossRefPubMed
80.
go back to reference Schwartz, A. R., Thut, D. C., Russ, B., et al. (1993). Effect of electrical stimulation of the hypoglossal nerve on airflow mechanics in the isolated upper airway. The American Review of Respiratory Disease, 147, 1144–1150.PubMed Schwartz, A. R., Thut, D. C., Russ, B., et al. (1993). Effect of electrical stimulation of the hypoglossal nerve on airflow mechanics in the isolated upper airway. The American Review of Respiratory Disease, 147, 1144–1150.PubMed
81.
go back to reference Miki, H., Hida, W., Shindoh, C., et al. (1989). Effects of electrical stimulation of the genioglossus on upper airway resistance in anesthetized dogs. The American Review of Respiratory Disease, 140, 1279–1284.PubMed Miki, H., Hida, W., Shindoh, C., et al. (1989). Effects of electrical stimulation of the genioglossus on upper airway resistance in anesthetized dogs. The American Review of Respiratory Disease, 140, 1279–1284.PubMed
82.
go back to reference Schwartz, A. R., Bennett, M. L., Smith, P. L., et al. (2001). Therapeutic electrical stimulation of the hypoglossal nerve in obstructive sleep apnea. Archives of Otolaryngology—Head & Neck Surgery, 127, 1216–1223. Schwartz, A. R., Bennett, M. L., Smith, P. L., et al. (2001). Therapeutic electrical stimulation of the hypoglossal nerve in obstructive sleep apnea. Archives of Otolaryngology—Head & Neck Surgery, 127, 1216–1223.
83.
go back to reference Kezirian, E. J., Boudewyns, A., Eisele, D. W., et al. (2010). Electrical stimulation of the hypoglossal nerve in the treatment of obstructive sleep apnea. Sleep Medicine Reviews, 14(5), 299–305.CrossRefPubMed Kezirian, E. J., Boudewyns, A., Eisele, D. W., et al. (2010). Electrical stimulation of the hypoglossal nerve in the treatment of obstructive sleep apnea. Sleep Medicine Reviews, 14(5), 299–305.CrossRefPubMed
Metadata
Title
Cardiovascular Implications in the Treatment of Obstructive Sleep Apnea
Authors
Olivier M. Vanderveken
An Boudewyns
Quan Ni
Bhavani Kashyap
Johan Verbraecken
Wilfried De Backer
Paul Van de Heyning
Publication date
01-02-2011
Publisher
Springer US
Published in
Journal of Cardiovascular Translational Research / Issue 1/2011
Print ISSN: 1937-5387
Electronic ISSN: 1937-5395
DOI
https://doi.org/10.1007/s12265-010-9238-y

Other articles of this Issue 1/2011

Journal of Cardiovascular Translational Research 1/2011 Go to the issue