Clinical year in review: sleep disordered breathing

Sleep disordered breathing (mostly obstructive and central sleep apnea) are very common in the adult population, although a majority of the patients are not diagnosed. Obstructive sleep apnea is now an accepted independent risk factor for arterial hypertension and there is accumulating evidence that this form of sleep disordered breathing is associated with a significantly increased risk to develop coronary artery disease. Furthermore, studies show that the treatment of obstructive sleep apnea is beneficial in these patients. Central sleep apnea can be detected in 40% of the patients with systolic heart failure and may result from the cardio-respiratory changes in these patients. Patients responding effectively to the treatment of the central sleep apnea may also benefit by an improved clinical outcome. Given the high prevalence of sleep disordered breathing in the community, the fact that the majority of patients are not diagnosed and that sleep disordered breathing syndromes seem to have a major impact on development and progression of cardiovascular disease, sleep disordered breathing should be considered with increased awareness in the general population.