Obstructive sleep apnea: what does the cardiovascular physician need to know?

Obstructive sleep apnea (OSA) is a common disorder in adults. It is becoming increasingly recognized as a risk factor for cardiovascular diseases such as hypertension, pulmonary hypertension, myocardial infarction, and stroke. Knowing the pathophysiologic effects that occur during obstructive apnea assists in understanding how chronic complications and sequelae develop. OSA is also being recognized as associated with glucose intolerance and motor vehicle accidents. Polysomnography in a sleep laboratory remains the diagnostic method of choice. Treatment options are somewhat limited in scope, but nasal continuous positive airway pressure is the first line and has been shown to clearly improve many of the symptoms and sequelae of the syndrome. Cardiovascular physicians require a working knowledge of OSA and its complications, as many of the diseases they manage have shown links to this sleep disorder.