Obstructive sleep apnoea and comorbidity - an overview of the association and impact of continuous positive airway pressure therapy.

Obstructive sleep apnoea and comorbidity - an overview of the association and impact of continuous positive airway pressure therapy. Expert Rev Respir Med. 2019 Jan 28;: Authors: McNicholas WT Abstract INTRODUCTION: Obstructive sleep apnoea (OSA) is highly prevalent and there is considerable evidence supporting an independent association with a wide range of co-morbidities including cardiovascular, endocrine and metabolic, neuropsychiatric, pulmonary, and renal. Areas covered: A PubMed search of all the recent literature relating to OSA and co-morbidities was undertaken to critically evaluate the potential relationships and possible benefit of continuous positive airway pressure (CPAP) therapy. Expert Commentary: The evidence supporting an independent association is stronger for some co-morbidities than others and in cardiovascular diseases is strongest for hypertension and atrial fibrillation. Potential mechanisms include intermittent hypoxia, fluctuating intrathoracic pressure, and recurring micro-arousals that trigger cell and molecular consequences including sympathetic excitation, systemic inflammation and oxidative stress, in addition to metabolic and endothelial dysfunction. Different mechanisms may predominate in individual co-morbidities. Recent long term randomised controlled trials have cast doubt on benefits to co-morbidities from CPAP therapy of OSA, especially where co-morbidities are already established. However, benef...
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research