An abundance of evidence exists in support of primary and secondary prevention for tackling the scourge of cardiovascular disease. Despite our wealth of knowledge, certain deficiencies still remain. One such example is the association between sleep disordered breathing (SDB) and cardiovascular disease. A clear body of evidence exists to link these two disease entities (independent of other factors such as obesity and smoking), yet our awareness of this association and its clinical implication does not match that of other established cardiovascular risk factors. Here, we outline the available evidence linking SDB and cardiovascular disease as well as discussing the potential consequences and management in the cardiovascular disease population. 1. Sleep Disordered Breathing and Cardiovascular Disease 1.1. Opening Statement Sleep disordered breathing (SDB), encompassing both obstructive and central sleep apnoea, has been associated with increased cardiovascular morbidity and mortality. It occurs in half of all heart failure patients and is linked to hypertension, arrhythmia, impaired glucose tolerance, cerebrovascular disease, and ischaemic heart disease [1–3]. Despite the high prevalence and significant morbidity associated with SDB, our awareness and understanding of this condition remain incomplete. 1.2. Introduction An abundance of evidence exists in support of primary and secondary prevention for tackling the scourge of cardiovascular disease. Despite our wealth of knowledge, certain deficiencies still remain. One such example is the association between SDB and cardiovascular disease. A clear body of evidence exists to link these two disease entities (independent of other factors such as obesity and smoking) yet our awareness of this association and its clinical implication does not match that of other established cardiovascular risk factors [4, 5]. Here, we outline the available evidence linking SDB and cardiovascular disease as well as discussing the potential consequences and management in the cardiovascular disease population. 2. Sleep Disordered Breathing and Its Apnoeic Subtypes: Obstructive or Central? Sleep apnoea can be defined as the cessation of breathing during sleep which lasts for at least 10 seconds, on five or more occasions per hour, and which leads to tiredness during the daytime [6]. Presenting symptoms may include morning headaches, unrefreshing sleep, and the effects of increased daytime somnolence (poor concentration, mood changes, and reduced libido). In over 80% of cases, however, individuals suffering from sleep apnoea will be
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