Sleep Apnea and Sudden Cardiac Death

Abstract

Sleep plays an integral role in maintaining health and quality of life. Obstructive sleep apnea (OSA) is a prevalent sleep disorder recognized as a risk factor for cardiovascular disease and arrhythmia. Sudden cardiac death (SCD) is a common and devastating event. Out-of-hospital SCD accounts for the majority of deaths from cardiac disease, which is the leading cause of death globally. A limited but emerging body of research has further elaborated on the link between OSA and SCD. In this article, we aim to provide a critical review of the existing evidence by addressing the following questions: (1) what epidemiologic evidence exists linking OSA to SCD; (2) what evidence exists for a pathophysiologic connection between OSA and SCD; (3) are there electrocardiographic markers of SCD found in patients with OSA; (4) does heart failure represent a major effect modifier regarding the relationship between OSA and SCD; and (5) what is the impact of sleep apnea treatment on SCD and cardiovascular outcomes. Finally, we elaborate on ongoing research to enhance our understanding of the OSA-SCD association.