Clinical Consequences of Obstructive Sleep Apnea

Abstract

The clinical consequences of obstructive sleep apnea (OSA) can be grouped in two categories: sleepiness and performance decrements and cardiovascular dysfunction. OSA patients demonstrate excessive sleepiness that causes cognitive impairments, including decrements in attention, vigilance, memory, learning abilities, and mood. As a result, OSA patients have an increased risk for motor vehicle accidents. Acute oscillations in heart rate, systemic and pulmonary pressures, and cardiac output accompany the apneic episodes due to the repetitive hypoxemia and arousals that accompany the apneas. Available evidence suggests OSA can lead to chronic systemic hypertension and, when accompanied by disorders causing waking hypoxemia, pulmonary hypertension. Establishing a causal relationship between OSA and myocardial infarction, cerebrovascular disease, or worsened mortality is more difficult because of the lack of prospective randomized trials; more investigations are needed. OSA can complicate pulmonary procedures and increase perioperative morbidity, but recognition and treatment of the disorder can decrease the risks.

Key Words:

sleep apnea syndrome - hypersomnolence - hypertension