الفهرس 
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Abstract
Obstructive sleep apnea is common in the general population and has been implicated in adverse cardiovascular effects. It is associated with hypertension. Continuous positive airway pressure
(CPAP) reduces both nocturnal and daytime blood pressure, in part by attenuating sympathetic nervous activity. Obstructive sleep apnea
appears to be a potential risk factor for ischemic heart disease. It has
been associated with nocturnal ST-segment depression in patients with
coronary heart disease, and may affect outcome adversely in patients
with coronary artery disease. Sleep-disordered breathing, both
obstructive and central, is seen commonly in patients with CHF and is
associated with an increased risk of arrhythmias (atrial fibrillation).
Daytime sleepiness and snoring are the most common
symptoms. OSAS is considered a risk for traffic accidents due to
sleepiness. It has also been suggested that sleep apnea is a risk factor
for cardiovascular disease, diabetes mellitus and early death. The most
common treatments are continuous positive airway pressure (CPAP),
mandibular repositioning appliances and various surgical modalities.
A number of other treatments and lifestyle modifications have been
suggested. A diversity of portable simplified diagnostic equipment has
been introduced due to the high cost of overnight polysomnograms.
The apnoea-hypopnoea index (AHI) is the mean number of
apneas and hypopneas per hour of sleep, and an AHI greater than 5 is
considered pathological. Overnight polysomnography–including
respiratory monitoring, pulse oximetry, electrocardiogram (ECG) and
sleep staging with electroencephalogram (EEG) – is the reference
diagnostic procedure.
Summary and Conclusion
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Treatment of OSA with CPAP improves ejection fraction in
patients with CHF. Obstructive sleep apnea may be associated with
ventricular arrhythmias, pulmonary hypertension; several mechanisms
could explain the relationship of OSA with the development of
atherosclerosis, including abnormalities in various inflammatory and
metabolic factors that have been associated with endothelial
dysfunction and the development of atherosclerosis. On the basis of
the evidence accumulated in the literature, it appears that OSA is an
important risk factor for the development of cardiovascular disease.
Clinicians caring for patients with cardiovascular should be aware of
these associations and should attempt to identify patients with OSA.