HealthDay News — People with cardiovascular risk factors or conditions should be screened for obstructive sleep apnea (OSA), according to a scientific statement issued by the American Heart Association and published online June 21 in Circulation.
Yerem Yeghiazarians, M.D., from the University of California in San Francisco, and colleagues note that the prevalence of OSA is as high as 40 to 80 percent in patients with hypertension, heart failure, coronary artery disease, pulmonary hypertension, atrial fibrillation, and stroke, but OSA is often underrecognized and undertreated. They developed recommendations for addressing OSA in cardiovascular practice.
The authors recommend OSA screening for patients with resistant/poorly controlled hypertension, pulmonary hypertension, and recurrent atrial fibrillation after cardioversion or ablation. A formal sleep assessment is reasonable in patients with New York Heart Association class II to IV heart failure and suspicion of sleep-disordered breathing or excessive daytime sleepiness. Evaluation for sleep apnea should be considered in patients with tachy-brady syndrome or ventricular tachycardia or survivors of sudden cardiac death in whom sleep apnea is suspected. Comorbid sleep apnea may be especially likely for patients with nocturnally occurring angina, myocardial infarction, arrhythmias, or appropriate shocks from implanted cardioverter-defibrillators. Treatment should be considered for all patients with OSA, including behavioral modifications and weight loss. Patients with severe OSA should be offered continuous positive airway pressure, while oral appliances can be considered for mild-to-moderate OSA.
“The overall message is clear: we need to increase awareness about screening for and treating OSA, especially in patients with existing cardiovascular risk factors,” Yeghiazarians said in a statement.
Two authors disclosed financial ties to the pharmaceutical industry.