Obstructive Sleep Apnea and Arrhythmias in the Elderly
| Autor: | Chi-Hang Lee, Eugene S. J. Tan |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty business.industry medicine.medical_treatment Atrial fibrillation medicine.disease nervous system diseases respiratory tract diseases Hypoxemia Sudden cardiac death Obstructive sleep apnea Coronary artery disease stomatognathic system Neurology Heart failure Internal medicine medicine Cardiology Neurology (clinical) Continuous positive airway pressure medicine.symptom business Hypopnea |
| Zdroj: | Current Sleep Medicine Reports. 7:197-205 |
| ISSN: | 2198-6401 |
| Popis: | Obstructive sleep apnea (OSA) is more common in the elderly and carries a unique phenotype. Elderly patients with OSA are less symptomatic and have less hypopnea but worse hypoxemia. Repetitive hypoxemic insults during sleep increase the prevalence of nocturnal arrhythmias in OSA, which may manifest as bradyarrhythmias, atrial fibrillation, ventricular arrhythmias, and sudden cardiac death. However, arrhythmogenesis in elderly OSA patients is complex and involves interactions between OSA, aging, and cardiovascular risk factors. In OSA, hypoxemia, intrathoracic pressure changes, inflammation, increased sympathetic activation, and cardiac structural and electrical alterations contribute to arrhythmia development. Structural, functional, molecular, and cellular alterations that occur in the heart with aging and cellular senescence further increase the propensity to arrhythmias. Finally, comorbidities common to age and OSA, including hypertension, metabolic syndrome, coronary artery disease, heart failure, and renal impairment, further add to the increased arrhythmogenic susceptibility. Continuous positive airway pressure therapy is an established therapy in OSA but its efficacy in arrhythmia prevention is uncertain. Limitations in acceptance and adherence among the elderly add to the difficulty in ascertaining its benefits in arrhythmic reduction. In summary, OSA and aging increase the predisposition to arrhythmias through complex interactions of pathways underlying OSA, age, and shared risk factors. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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