CVD Risk Heightened in Certain OSA Patients

New research has indicated that various cardiovascular events, such as myocardial infarction (MI) and stroke, are more likely to occur in patients with obstructive sleep apnea (OSA) that occurs primarily during rapid eye movement (REM) sleep, and those with prevalent cardiovascular disease (CVD).

In the Sleep Heart Health Study, researchers monitored 3265 individuals with non-REM apnea–hypopnea index (AHI) of less than 5 events per hour for the occurrence of fatal and nonfatal MI, coronary artery revascularization, congestive heart failure, and stroke.

Adjusted hazard ratios (aHR) for a composite of these events were calculated via proportional hazards regression.

According to study findings, the aHR for cardiovascular events in patients with severe REM OSA (n = 180), defined as the occurrence of at least 30 events, was 1.35.

The researchers noted that this association was most prominent in patients with prevalent CVD and severe OSA during REM sleep (aHR 2.56).

“Severe OSA that occurs primarily during REM sleep is associated with higher incidence of a composite cardiovascular endpoint, but in only those with prevalent cardiovascular disease,” the researchers concluded.

—Christina Vogt

Reference:

Aurora RN, Crainiceanu C, Gottlieb DJ, Kim JS, Punjabi NM. Obstructive sleep apnea during REM sleep and cardiovascular disease. Am J Respir Crit Care Med. 2018;197(5). https://doi.org/10.1164/rccm.201706-1112OC.