Herz.2006 May;31(3):213-218
Grimm W, Becker HF
Obstructive sleep apnoea is a common disorder and affects approximately 4% of middle-aged men and 2% of middle-aged women. Obstructive sleep apnoea is clearly associated with obesity, with more than 50% of patients having a body mass index > 30 kg/m(2).
Substantial evidence identified obstructive sleep apnoea as a risk factor not only for excessive daytime sleepiness and road traffic accidents, but also for increased cardiovascular disease and related deaths. In addition, all kinds of arrhythmias (abnormal rhythms) have been observed in patients with sleep apnoea ranging from asymptomatic excessive slowing of the heart to sudden cardiac death. Approximately 5-10% of patients with obstructive sleep apnoea show marked apnoea-related slowing of heart rate due to enhanced vagal tone (slowing nerve messages from brain to heart) and pronounced oxygen deficiency.
Therapeutic options in obese patients with obstructive sleep apnoea include consequent weight loss and nasal continuous positive airway pressure (CPAP) ventilation as the therapies of first choice. Weight reduction and effective nasal CPAP therapy significantly decrease heart related death and disease and eliminate sleep-related bradyarrhythmias in 80-90% of patients obviating the need for pacemaker implantation in these patients.
