Obstructive Sleep Apnea and Systemic Diseases

Mo, Ji Hun

Abstract

As society industrializes and develops, people become increasingly concerned about quality of life and sleep-related disorders. Sleep disordered breathing (SDB) includes obstructive sleep apnea (OSA) and upper airway resistance syndrome. Most of the patients that snore have OSA, and OSA can result in not only cardiovascular and neuro-cognitive diseases but also in severe morbidities and mortalities; therefore, its importance cannot be emphasized too strongly. The mechanism by which OSA induces such morbidities is related to sleep fragmentation and intermittent hypoxia, which result in sympathetic activation, endothelial dysfunction, and metabolic dysregulation. All of these conditions produce a humoral imbalance, a hypercoagulable state, and atherosclerosis, which finally result in multi-morbidities. These comorbidities include cardiovascular, respiratory, neurologic, metabolic, and genitourinary disorders. The clinical relevance of OSA is mainly due to its strong association with morbidities such as hypertension, metabolic syndrome, diabetes, heart failure, coronary artery disease, arrhythmias, stroke, pulmonary hypertension, and neurocognitive and mood disorders. A high mortality rate has also been associated with OSA. It is important to acknowledge the comorbidities of OSA to achieve a better understanding of the disease and for better treatment of patients with OSA. In this review, the comorbidities of OSA will be discussed in detail.