Mohammad Hafizullah.
Sleep disordered breathing (sdb) and cardiovascular health.
Pak Heart J Jan ;49(3):91-4.

Sleep is important for health and breathing is essential for life. Disturbances in breathing during sleep - sleep disordered breathing (SDB) has been recognized as of paramount importance having immense effects on human health and healthcare system. Sleep apnea is a potentially life-threatening chronic disease that affects more than 12% U.S. adults. Two recent white papers commissioned bythe American Academy of Sleep Medicine (AASM) provide a detailed analysis of the huge economic burden associated with undiagnosed and untreated obstructive sleep apnea among adults in the United States. The white paper,"Hidden Health Crisis Costing America Billions," based on longitudinal data suggests that the estimated prevalence of OSA has increased substantially over the last two decades, and utilizing Frost & Sullivan's modeling and forecasting expertise, the paper estimates that OSA afflicts 29.4 million adults in the U.S. The estimated cost of diagnosing and treating OSA in the U.S. in 2015 was approximately $12.4 billion where as the estimated cost burden of undiagnosed OSA among U.S. adults was an astounding $149.6 billion in 2015. SDB is of great importance in the world of cardiology as this has been implied in causation and acceleration of coronary heart disease, systemic hypertension, pulmonary hypertension and arrhythmias. Prevalence of OSA in cardiovascular patients is 2 to 3 times higher than in reference populations without CVD. Population-based epidemiology studies and observations of OSA patients show that prevalence of hypertension, type II diabetes, cardiovascular disease, and stroke to be higher in people with OSA. The prevalence of SDB in CAD patients is up to 2-fold higher. We as cardiologists have to recognize that this area is in need of dedicated research to broaden the knowledge base. Specific questions that need answers include whether sleep apnea can initiate development of cardiac and vascular disease, whether sleep apnea in established cardiovascular disease patients accelerates disease progression, and whether treatment of sleep apnea will result in clinical improvement, fewer cardiovascular events and reduced mortality.

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