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Obstructive Sleep Apnea and the Risk of Sudden Cardiac Death: A Longitudinal Study of 10,701 Adults


#1

NOTE: This is not a new study, however, it was one of the largest research projects related to sleep disorders and cardiac issues. It led to numerous follow-up studies. The findings suggested the high risks of sudden cardiac death linked to obstructive sleep apnea

Abstract

Objective

To identify the risk of sudden cardiac death (SCD) associated with obstructive sleep apnea (OSA).

Background

Risk stratification for SCD, a major cause of mortality, is difficult. OSA is linked to cardiovascular disease and arrhythmias, and has been shown to increase the risk of nocturnal SCD. It is unknown if OSA independently increases the risk of SCD.

Methods

We included 10,701 consecutive adults undergoing their first diagnostic polysomnogram between 7/1987 and 7/2003. During follow-up up to 15 years, we assessed incident resuscitated or fatal SCD in relationship to the presence of OSA, physiological data including the apnea-hypopnea index (AHI) and nocturnal oxygen saturation (O2sat) parameters, and relevant comorbidities.

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Results

During an average follow-up of 5.3 years, 142 patients had resuscitated or fatal SCD (annual rate 0.27%). In multivariate analysis, independent risk factors for SCD were age, hypertension, coronary artery disease, cardiomyopathy or heart failure, ventricular ectopy or nonsustained ventricular tachycardia, and lowest nocturnal O2sat (per -10%, HR 1.14, P=0.029). SCD was best predicted by age >60 years (HR 5.53), AHI >20 (HR 1.60), mean nocturnal O2sat <93% (HR 2.93), and lowest nocturnal O2sat <78% (HR 2.60, all P<0.0001).

Conclusions

In a population of 10,701 adults referred for polysomnography, OSA predicted incident SCD, and the magnitude of risk was predicted by multiple parameters characterizing OSA severity. Nocturnal hypoxemia, an important pathophysiological feature of OSA, strongly predicted SCD independently of well-established risk factors. These findings implicate OSA, a prevalent condition, as a novel risk factor for SCD.

Read more here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3851022/

SOURCE: J Am Coll Cardiol. 2013 Aug 13; 62(7): 10.1016/j.jacc.2013.04.080.
Published online 2013 Jun 13. doi: 10.1016/j.jacc.2013.04.080


#2

I would like to hear your thoughts about this study about sleep apnea and sudden cardiac death. I am here to answer questions should you have any.

Some might like the data broken down. Would that be helpful?

Thanks in advance!


#3

MotherT,

I received your email and thank you for inviting me to your discussion about this study. One question that I have is if the subjects were only males? It only referenced males in the above table. I would like to get more info on the cardiac element as I suffer from moderate to severe mixed obstructive sleep apnea so I would like to get as much info as possible. After I read the study thoroughly, I may have more questions and/or ideas. I look forward to hearing from you.


#4

Yes, sleep apnea places a tremendous strain on your heart. This leads to various heart arrhythmias, such as atrial fibrillation, and hypertension. In the long run heart disease can take its toll and lead to sudden death.

And actually, women are more vulnerable to sleep apnea, Additionally, and even more alarming, if they come to the emergency room with chest pain, they’re also more likely to be misdiagnosed.

Both these factors put women at more risk for sudden death.


#5

I have been diagnosed with pulmonary hypertension due to undiagnosed sleep apnea.

I’m praying that using the CPAP will improve my medical condition. Has anyone else been diagnosed with this medical condition?