Obstructive sleep apnea and cardiovascular disease, a story of confounders!

Jacob Collen*, Christopher Lettieri, Emerson Wickwire, Aaron Holley

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

54 Scopus citations


Obstructive sleep apnea (OSA) syndrome is increasingly common among middle aged and older adults and is frequently linked to most cardiovascular diseases (CVD). Sleep-disordered breathing and CVD share a number of common risk factors and comorbid conditions including obesity, male gender, advancing age, metabolic syndrome, and hypertension. OSA appears to be associated with worsened CVD outcomes, sleep-related symptoms, quality of life, and risk of motor vehicle accidents. Demonstrating a cause-and-effect relationship between CVD and OSA has been challenging due to shared comorbidities. Strong evidence demonstrating clinically significant benefit for OSA treatments on OSA-related CVD outcomes are limited. In this review, we evaluate potential pathophysiologic mechanisms that link OSA to CVD and focus on specific treatments for OSA, including positive airway pressure (PAP), dental devices, and surgeries with regard to OSA-related CVD outcomes.

Original languageEnglish
Pages (from-to)1299-1313
Number of pages15
JournalSleep and Breathing
Issue number4
StatePublished - Dec 2020
Externally publishedYes


  • Atrial fibrillation
  • Cardiovascular disease
  • Cerebrovascular accident
  • Cerebrovascular disease
  • Congestive heart failure
  • Continuous positive airway pressure
  • Coronary artery disease
  • Hypertension
  • Obstructive sleep apnea
  • Positive airway pressure
  • Pulmonary hypertension


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