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Journal of the American College of Cardiology

Clinical Articles, Featured

Sleep apnoea experts concur on sudden death increased risk

A moderate case of obstructive sleep apnoea can significantly increase a person’s risk for sudden cardiac death, according to the largest study1 of its kind published online recently in the Journal of the American College of Cardiology.

Researchers in this study examined the relationship between sleep apnoea and sudden cardiac death, building off of their prior study that found people with sleep apnoea more frequently died suddenly from cardiac causes during the hours of 10 pm to 6 am, which is the least likely time for sudden cardiac death in the general population.

10,701 subjects were followed for an average of 5.3 years for incidents of resuscitated or fatal sudden cardiac death. In that time, 142 patients experienced sudden cardiac death, with the most common predictors being a patient aged 60 years, having 20 apnoea episodes an hour and having a lowest oxygen saturation level of below 78%.

Low oxygen saturation occurs when air does not flow into the lungs when a sleep apnoea patient is sleeping and as a result the patient’s blood oxygen levels drop. The study showed that a drop to below 78% increases that patients risk of sudden cardiac death by 80%.

The study clarifies that sleep apnoea patients’ risk of sudden cardiac death does not simply shift from daytime hours to night-time hours but that their overall risk of sudden cardiac death is higher than people without sleep apnoea.

Dr Apoor Gami (Midwest Heart Specialists, Illinois, USA)

Dr Apoor Gami

“The prevalence of obstructive sleep apnoea in Western populations is high and will likely only continue to grow given the obesity epidemic and direct relationship between obesity and sleep apnoea,” said lead author Dr Apoor Gami (Midwest Heart Specialists – Advocate Medical Group in Elmhust, Illinois, USA).

“Treating sleep apnoea in one person can improve the quality of life of both bed partners and may have the added benefit of helping to prevent cardiovascular disease,” said Dr Virend K Somers (Mayo Clinic College of Medicine in Rochester, Minnesota, USA). “If the spouse sees the bed partner stop breathing repeatedly during sleep, this is an important clue that he or she probably has sleep apnoea.”

For more information on sleep apnoea or sudden cardiac death, visit www.cardiosmart.org

Another form of sleep apnoea – central sleep apnoea with Cheyne Stokes respiration – is of particular importance in heart failure patients, but has received less in-depth investigation than obstructive sleep apnoea, according to an editorial2 by Professor Martin Cowie (Royal Brompton Hospital, London) published recently in the British Journal of Cardiology.

References

Cowie

Professor Martin Cowie

1. Gami AS, Olson EJ, Shen WK, et al. Obstructive sleep apnea and the risk of sudden cardiac death: a longitudinal study of 10,701 adults. J Am Coll Cardiol 2013. http://dx.doi.org/10.1016/j.jacc.2013.04.080

2. Cowie M. The SERVE-HF study: investigating the impact of central sleep apnoea on heart failure. Br J Cardiol 2013;20:50–1. http://dx.doi.org/10.5837/bjc.2013.011

Published on: June 20, 2013

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