Pathophysiologic Mechanisms of Cardiovascular Disease in Obstructive Sleep Apnea

The mechanisms underlying cardiovascular disease in patients with obstructive sleep apnea are still poorly understood. The pathogenesis is likely to be a multifactorial process involving a diverse range of mechanisms, including sympathetic nervous system overactivity, selective activation of inflammatory pathways, endothelial dysfunction, and metabolic dysregulation, the latter particularly involving insulin resistance and disordered lipid metabolism. This sleep breathing disorder is thought to contribute to, or be a cause of systemic hypertension, atherosclerosis, coronary artery disease, heart failure, atrial fibrillation, and stroke.