Obstructive sleep apnea as a potentially reversible cause of nighttime bradyarrhythmias. Clinical case

Cover Page

Cite item

Full Text

Abstract

Obstructive sleep apnea syndrome is a common condition, especially among obese patients. Patients with obstructive sleep apnea syndrome have an increased risk of developing arterial hypertension and cardiovascular events, as well as cardiac arrhythmias, which include reflexively occurring bradyarrhythmias and episodes of asystole at night. Treatment of obstructive sleep apnea syndrome leads to an improvement in the patient’s quality of life and also reduces cardiovascular risk and eliminates associated bradyarrhythmias during night sleep.

About the authors

Natalia G. Kucherenko

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: nataliadoc@mail.ru
ORCID iD: 0000-0002-7152-0615
SPIN-code: 6207-9387

Cand. Sci. (Med.), Assistant Professor

Russian Federation, Saint Petersburg

Anton N. Bebekh

North-Western State Medical University named after I.I. Mechnikov

Email: vizier3@yandex.ru
ORCID iD: 0000-0003-4401-2567
SPIN-code: 9867-9220

assistant lecturer

Russian Federation, Saint Petersburg

Irina A. Umarova

North-Western State Medical University named after I.I. Mechnikov

Email: iumarova@mail.ru
SPIN-code: 8732-9306

Cand. Sci. (Med.); Assistant Professor

Russian Federation, Saint Petersburg

Aigul R. Abukova

North-Western State Medical University named after I.I. Mechnikov

Email: abukova.97@mail.ru

resident

Russian Federation, Saint Petersburg

References

  1. Guilleminault C, Tilkian A, Dement WC. The sleep apnea syndromes. Annu Rev Med. 1976;27:465–484. doi: 10.1146/annurev.me.27.020176.002341
  2. Kapur V, Strohl KP, Redline S, et al. Underdiagnosis of sleep apnea syndrome in U.S. communities. Sleep Breath. 2002;6(2):49–54. doi: 10.1007/s11325-002-0049-5
  3. Benjafield AV, Ayas NT, Eastwood PR, et al. Estimation of the global prevalence and burden of obstructive sleep apnea: a literature-based analysis. The Lancet. Respir Med. 2019;7(8):687–698. doi: 10.1016/S2213-2600(19)30198-5
  4. Gottlieb DJ, Punjabi NM. Diagnosis and management of obstructive sleep apnea: a review. JAMA. 2020;323(14):389–1400. doi: 10.1001/jama.2020.3514
  5. Manuel AR, Hart N, Stradling JR. Correlates of obesity-related chronic ventilatory failure. BMJ. 2016;3(1):e000110. doi: 10.1136/bmjresp-2015-000110
  6. Patinkin ZW, Feinn R, Santos M. Metabolic consequences of obstructive sleep apnea in adolescents with obesity: a systematic literature review and meta-analysis. Childhood Obesity. 2017;13(2):102–110. doi: 10.1089/chi.2016.0248
  7. Rapoport DM, Garay SM, Epstein H, Goldring RM. Hypercapnia in the obstructive sleep apnea syndrome. A reevaluation of the “Pickwickian syndrome”. Chest. 1986;89(5):627–635. doi: 10.1378/chest.89.5.627
  8. Kapur VK, Auckley DH, Chowdhuri S, et al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2017;13(3):479–504. doi: 10.5664/jcsm.6506
  9. Yeghiazarians Y, Jneid H, Tietjens JR, et al. Obstructive sleep apnea and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2021;144(3):56–67. doi: 10.1161/CIR.0000000000000988
  10. Mann D, Zipes D, Libby P, Bonow R. Braunwald’s heart disease: a textbook of cardiovascular medicine. 11th ed. Philadelphia (PA): Elsevier/Saunders; 2015.
  11. Vetulli HM, Elizari MV, Naccarelli GV, Gonzalez MD. Cardiac automaticity: basic concepts and clinical observations. J Interv Card Electrophysiol. 2018;52(3):263–270. doi: 10.1007/s10840-018-0423-2
  12. Drager LF, Bortolotto LA, Figueiredo AC, et al. Obstructive sleep apnea, hypertension, and their interaction on arterial stiffness and heart remodeling. Chest. 2007;131(5):1379–1386. doi: 10.1378/chest.06-2703
  13. Chadda KR, Fazmin IT, Ahmad S, et al. Arrhythmogenic mechanisms of obstructive sleep apnea in heart failure patients. Sleep. 2018;41(9):zsy136. doi: 10.1093/sleep/zsy136
  14. Semelka M, Wilson J, Floyd R. Diagnosis and treatment of obstructive sleep apnea in adults. Am Fam Physician. 2016;94(5): 355–360.
  15. Tung P, Levitzky YS, Wang R, et al. Obstructive and central sleep apnea and the risk of incident atrial fibrillation in a community cohort of men and women. J Am Heart Assoc. 2017;6(7):e004500. doi: 10.1161/JAHA.116.004500
  16. Kharats VE. The problem of association between obstructive sleep apnea and atrial fibrillation in cardiology practice. The Siberian Journal of Clinical and Experimental Medicine. 2022;37(3):41–48. (In Russ.) EDN: SEKBFJ doi: 10.29001/2073-8552-2022-37-3-41-48
  17. Linz D, McEvoy RD, Cowie MR, et al. Associations of obstructive sleep apnea with atrial fibrillation and continuous positive airway pressure treatment: a review. JAMA Cardiology. 2018;3(6):532–540. doi: 10.1001/jamacardio.2018.0095
  18. Poluektov MG. Primary and secondary insomnias and sleep related breathing disturbances. S.S. Korsakov Journal of Neurology and Psychiatry. 2011;111(9(2)):10–18. (In Russ.) EDN: PYWSMD
  19. Lipford MC, Flemming KD, Calvin AD, et al. Associations between cardioembolic stroke and obstructive sleep apnea. Sleep. 2015;38(11):1699–1705. doi: 10.5665/sleep.5146
  20. Zorina AV, Kulagina AM, Kazarina AV, et al. Obstructive sleep apnea in patients with atrial fibrillation. Neurological Journal. 2017;22(4): 177-81. (In Russ.) doi: 10.18821/1560-9545-2017-22-4-177-181
  21. Buzunov RV, Legeyda IV, Tsareva EV. Snoring and obstructive sleep apnea in adults and children. Guidelines for doctors. Moscow; 2013. 124 p. (In Russ.)
  22. Sahlin C, Sandberg O, Gustafson Y, et al. Obstructive sleep apnea is a risk factor for death in patients with stroke: a 10-year follow-up. Arch Intern Med. 2008;168(3):297–301. doi: 10.1001/archinternmed.2007.70
  23. Kuznetsov AN, Vinogradov O1. Ischemic stroke. Diagnosis, treatment, prevention. Pocket guide. 3rd ed. Moscow: RAEN; 2014. 90 p. (In Russ.)
  24. Lavergne F, Morin L, Armitstead J, et al. Atrial fibrillation and sleep-disordered breathing. J Thorac Dis. 2015;7(12):575–584. doi: 10.3978/j.issn.2072-1439.2015.12.57
  25. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur J Cardiothorac Surg. 2016;50(5):1–88. doi: 10.1093/ejcts/ezw313
  26. Zwillich C, Devlin T, White D, et al. Bradycardia during sleep apnea. Characteristics and mechanism. J Clin Invest. 1982;69(6):1286–1292. doi: 10.1172/jci110568
  27. Becker H, Brandenburg U, Peter JH, Von Wichert P. Reversal of sinus arrest and atrioventricular conduction block in patients with sleep apnea during nasal continuous positive airway pressure. Am J Respir Crit Care Med. 1995;151(1):215–218. doi: 10.1164/ajrccm.151.1.7812557
  28. Patil SP, Ayappa IA, Caples SM, et al. Treatment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine systematic review, meta-analysis, and grade assessment. J Clin Sleep Med. 2019;15(2):301–334. doi: 10.5664/jcsm.7638
  29. Mokhlesi B, Masa JF, Brozek JL, et al. Evaluation and management of obesity hypoventilation syndrome. An official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 2019;200(3):6–24. doi: 10.1164/rccm.201905-1071ST
  30. Sullivan CE, Issa FG, Berthon-Jones M, Eves L. Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet. 1981;1(8225):862–865. doi: 10.1016/s0140-6736(81)92140-1
  31. Patil SP, Ayappa IA, Caples SM, et al. Treatment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2019;15(2):335–343. doi: 10.5664/jcsm.7640
  32. Buzunov RV, Palman AD, Melnikov AYu, et al. Diagnostics and treatment of obstructive sleep apnea syndrome in adults. Recommendations of the Russian society of sleep medicine. Effective pharmacotherapy. Neurology and Psychiatry. Special issue «Sleep and Sleep Disorders». 2018;35:34–45. (In Russ.)
  33. Grimm W, Hoffmann J, Menz V, et al. Electrophysiologic evaluation of sinus node function and atrioventricular conduction in patients with prolonged ventricular asystole during obstructive sleep apnea. Am J Cardiol. 1996;77(15):1310–1314. doi: 10.1016/s0002-9149(96)00197-x

Copyright (c) 2024 Eco-Vector

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies